Individual provider Active NPI

Deborah Radford

  • Medical Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1124573506
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
020020 Issued in NY
Practice address
9425 60TH Ave
Elmhurst, NY 11373-5069
Phone
(404) 558-2852
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 020020 NY Primary

Addresses

Primary practice location

9425 60TH Ave
Elmhurst, NY 11373-5069

Mailing address

9425 60TH Ave
Elmhurst, NY 11373-5069
Phone (404) 558-2852

Other names 1

  • Deborah Radford Professional name

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
I20170210000139 NY Practitioner - Physician Assistant 2668755000 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Josef Schenker MD PCGroup PAC ID 8022335330, 57 clinicians

Practice addresses (Care Compare)

1811 Ave J
Brooklyn, NY 11230-3808
Phone (718) 534-0689

4426 18TH Ave
Brooklyn, NY 11204-1201
Phone (718) 635-9700

6122 Fresh Pond Rd
Middle Village, NY 11379-1040
Phone (718) 502-3000

6402 108TH St
Forest Hills, NY 11375-1604
Phone (212) 734-6621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020020NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sure Care Medical P C Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1124573506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 60TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735069",
            "telephone_number": "404-558-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 60TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735069",
            "telephone_number": "404-558-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "020020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "RADFORD",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.