Individual provider Active NPI

Cyntia F Andrade Santamaria, PA

  • Physician Assistant
  • Forest Hills, NY
National Provider Identifier
1093552390
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10721 Queens Blvd Ste 9
Forest Hills, NY 11375-4451
Phone
(718) 285-7585
Fax
(212) 202-4884
NPI assigned
Jul 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 Primary

Addresses

Primary practice location

10721 Queens Blvd Ste 9
Forest Hills, NY 11375-4451

Mailing address

119 Demott Ave
Clifton, NJ 07011-3309
Phone (201) 233-1273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1093552390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 DEMOTT AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113309",
            "telephone_number": "201-233-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 QUEENS BLVD STE 9",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754451",
            "telephone_number": "718-285-7585",
            "fax_number": "212-202-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE SANTAMARIA",
        "first_name": "CYNTIA",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.