Individual provider Active NPI

Magdalena Godlewska, PA-C

  • Physician Assistant
  • Oceanside, NY
National Provider Identifier
1104365758
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020557-1 Issued in NY
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3000
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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 020557-1 NY Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

379 Clocks Blvd
Massapequa, NY 11758-7707
Phone (631) 223-5842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170501000833 NY Practitioner - Physician Assistant 8123304342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Sinai School of MedicineGroup PAC ID 6406096544, 150 clinicians

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020557NYMDClinical Social Worker
020557-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients

Locations

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: magdalenagodlewska@imppllc.allscriptsdirect.net

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1104365758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 CLOCKS BLVD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587707",
            "telephone_number": "631-223-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODLEWSKA",
        "first_name": "MAGDALENA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020557-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.