Active NPI
Stella Abayeva, P.A.
- Medical Physician Assistant
- Forest Hills, NY
National Provider Identifier
1124326467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 014655
- Practice address
- 10025 Queens Blvd Ste 1N
Forest Hills, NY 11375-2450 - Phone
- (718) 896-2333
- NPI assigned
- Mar 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 014655 | NY | Primary |
Addresses
Primary practice location
10025 Queens Blvd Ste 1N
Forest Hills, NY 11375-2450
Mailing address
6714 Thornton PL
Forest Hills, NY 11375-4129
Phone (917) 209-4244
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140807000313 | NY | Practitioner - Physician Assistant | 3476770900 | Reassigns benefits to 4 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amb Medical Services PC
Practice addresses (Care Compare)
6655 Fresh Pond Rd
Ridgewood, NY 11385-3261
Phone (718) 497-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014655 | NY | MD | Mental Health Counselor |
Organizations & group practices 4
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.
-
- Neurology Physician
- Port Jefferson Station, NY
- NPI 1639804628
NY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1124326467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6714 THORNTON PL",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754129",
"telephone_number": "917-209-4244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10025 QUEENS BLVD STE 1N",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752450",
"telephone_number": "718-896-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABAYEVA",
"first_name": "STELLA",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2022-02-04",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "014655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.