Individual provider Active NPI

Dennis James Kwiecinski

  • Physician Assistant
  • New York, NY
National Provider Identifier
1104439710
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 Central Park S Apt 107
New York, NY 10019-1449
Phone
(800) 545-7546
NPI assigned
Aug 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

200 Central Park S Apt 107
New York, NY 10019-1449

Mailing address

200 Central Park S Apt 107
New York, NY 10019-1449
Phone (800) 545-7546

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
I20201120000129 NY Practitioner - Physician Assistant 9335550490 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cindy Hoffman DO PCGroup PAC ID 6608979513, 8 clinicians

Practice addresses (Care Compare)

2050 Saw Mill River Rd
Suite 3
Yorktown Heights, NY 10598-4144
Phone (914) 736-1805

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of New York, PC CurrentSince Oct 26, 2020 Accepting new patients
Cindy Hoffman DO PC CurrentSince Nov 1, 2025 Accepting new patients
David S Cho, MD, PLLC Past Accepting new patients
Howard D. Solomon, DO, PC Past Accepting new patients

Locations

291 E 149th St
Bronx, NY 10451
Phone (718) 742-1000

686 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 279-1111

4 Crumwold Pl
Hyde Park, NY 12538
Phone (845) 229-2123

6 Lowell Ave
New Hyde Park, NY 11040
Phone (516) 326-4160

200 Central Park S
Apt 107
New York, NY 10019
Phone (212) 262-2500

2050 Saw Mill River Rd
Ste 3
Yorktown Heights, NY 10598
Phone (914) 617-8500

2050 Saw Mill River Rd
Yorktown Heights, NY 10598
Phone (914) 245-7888

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1104439710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CENTRAL PARK S APT 107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191449",
            "telephone_number": "800-545-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CENTRAL PARK S APT 107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191449",
            "telephone_number": "800-545-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIECINSKI",
        "first_name": "DENNIS",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.