Individual provider Active NPI

Kalyn Cedrowski

  • Physician Assistant
  • New York, NY
National Provider Identifier
1093183345
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00374100 Issued in NJ
Practice address
14 W 14TH St
New York, NY 10011-7524
Phone
(212) 390-0558
NPI assigned
Sep 3, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00374100 NJ Primary

Addresses

Primary practice location

14 W 14TH St
New York, NY 10011-7524

Mailing address

14 W 14TH St
New York, NY 10011-7524
Phone (212) 390-0558

Other practice location 1

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151016001707 NJ Practitioner - Physician Assistant 7416266283 Reassigns benefits to 1 organization
I20171206000458 NY Practitioner - Physician Assistant 7416266283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020775NYMDPediatric Occupational Therapist
25MP00374100NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Aug 12, 2019 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Aug 12, 2017 Accepting new patients
Summit Medical Group PA CurrentSince Aug 12, 2019 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Aug 12, 2017 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: kalyn.cedrowski.1@2983.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093183345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117524",
            "telephone_number": "212-390-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 W 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117524",
            "telephone_number": "212-390-0558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Clara Maass Dr",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "NJ",
            "postal_code": "071093550",
            "country_code": "US",
            "telephone_number": "973-450-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEDROWSKI",
        "first_name": "KALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00374100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.