Individual provider Active NPI

Elizabeth Ann Durchhalter, PA-C

  • Physician Assistant
  • Hicksville, NY
National Provider Identifier
1114764040
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032287 Issued in NY
Practice address
400 S Oyster Bay Rd Ste 100
Hicksville, NY 11801-3500
Phone
(516) 933-1717
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 032287 NY Primary

Addresses

Primary practice location

400 S Oyster Bay Rd Ste 100
Hicksville, NY 11801-3500

Mailing address

400 S Oyster Bay Rd Ste 100
Hicksville, NY 11801-3500
Phone (516) 933-1717

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
I20241018000061 NY Practitioner - Physician Assistant 8426598111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, New York, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allure Dermatology PLLCGroup PAC ID 3274929468, 4 clinicians

Practice addresses (Care Compare)

400 S Oyster Bay Rd
Suite 100
Hicksville, NY 11801-3500
Phone (516) 933-1717

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mariel Eliza, M.D., PLLC CurrentSince Jul 21, 2024 Accepting new patients

Locations

400 S Oyster Bay Rd
Ste 100
Hicksville, NY 11801
Phone (516) 234-0073

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1114764040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD STE 100",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-933-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD STE 100",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-933-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURCHHALTER",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.