Individual provider Active NPI

Kathleen Noriega, PA-C

  • Physician Assistant
  • Bronxville, NY
National Provider Identifier
1114793551
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030971 Issued in NY
Practice address
55 Palmer Ave
Bronxville, NY 10708-3403
Phone
(914) 787-1000
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 030971 NY Primary

Addresses

Primary practice location

55 Palmer Ave
Bronxville, NY 10708-3403

Mailing address

2018 Colden Ave
Bronx, NY 10462-3124

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
I20260226004537 NY Practitioner - Physician Assistant 8628559697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 Kelby St
FL 9
Fort Lee, NJ 07024-2939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030971NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients

Locations

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1114793551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 COLDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104623124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PALMER AVE",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083403",
            "telephone_number": "914-787-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORIEGA",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

Verify at the official NPI Registry.