NPIMap

Individual provider Active NPI

Jillian Palma, PA

  • Surgical Physician Assistant
  • Uniondale, NY
National Provider Identifier
1114762101
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
333 Earle Ovington Blvd Ste 101
Uniondale, NY 11553-3645
Phone
(516) 222-8881
NPI assigned
Jul 1, 2024
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NY Primary

Addresses

Primary practice location

333 Earle Ovington Blvd Ste 101
Uniondale, NY 11553-3645

Mailing address

333 Earle Ovington Blvd Ste 101
Uniondale, NY 11553-3645
Phone (516) 222-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920002756 NY Practitioner - Physician Assistant 7719428481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy D. Groth MD PCGroup PAC ID 8921002320, 43 clinicians

Practice addresses (Care Compare)

994 W Jericho Tpke
Suite 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy D. Groth MD PC CurrentSince Nov 1, 2025 Accepting new patients
Mark Drakos MD PLLC Past Accepting new patients

Locations

1500 William Floyd Pkwy
Ste 201
Shirley, NY 11967
Phone (631) 205-0800

994 W Jericho Tpke
Ste 104
Smithtown, NY 11787
Phone (516) 400-3595

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1114762101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 EARLE OVINGTON BLVD STE 101",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115533645",
            "telephone_number": "516-222-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 EARLE OVINGTON BLVD STE 101",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115533645",
            "telephone_number": "516-222-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMA",
        "first_name": "JILLIAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniondale, NY

Sources for this page

Verify at the official NPI Registry.