Maria del Consuelo Alonso, PA
Individual provider Active NPI Medical Physician Assistant · Mineola, NY
NPI 1124207659 · NPPES record last updated Nov 1, 2007
Key facts
- NPI
- 1124207659
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 001374 (NY)
- Practice address
- 120 Mineola Blvd
Ste 210
Mineola, NY 11501-4073 - Phone
- (516) 663-3067
- Fax
- (516) 663-3070
- NPI assigned
- Nov 1, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110216000718 | NY | Practitioner - Physician Assistant | 9234310749 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001374 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Weill Medical College of Cornell | Current |
Accepting new patients | |
| Weill Medical College of Cornell | Current |
Accepting new patients |
Locations
50 E 69th St
New York, NY 10021
Phone (212) 570-4000
Interoperability endpoints
- maa4007@direct.nyp.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 001374 | NY | Yes |
Addresses
Primary practice location
120 Mineola Blvd
Ste 210
Mineola, NY 11501-4073
Mailing address
120 Mineola Blvd
Ste 210
Mineola, NY 11501-4073
Phone (516) 663-3067
Other providers in Mineola, NY
- Michele C Allan
- John Dennis Allendorf
- Meghan Quigley Allison
- Maria Mercedes Almonte Batista
- John Francis Aloia
- Steven Alper
- Rori Megan Alter
- Carly Alterman
- Amy Altmann
- Anthony Amador
All providers in Mineola, NY · Medical Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.