Individual provider Active NPI

Danielle Ann Zavarelli, PA

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1124759188
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008175-01 Issued in NY
Practice address
168 Hickory Ave
Staten Island, NY 10305-4418
Phone
(917) 319-8701
Fax
(718) 462-8000
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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 008175-01 NY Primary

Addresses

Primary practice location

168 Hickory Ave
Staten Island, NY 10305-4418

Mailing address

168 Hickory Ave
Staten Island, NY 10305-4418
Phone (917) 319-8701

Other names 1

  • Miss Danielle Ann Zavarelli Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008175-01NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1124759188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 HICKORY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054418",
            "telephone_number": "917-319-8701",
            "fax_number": "718-462-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 HICKORY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054418",
            "telephone_number": "917-319-8701",
            "fax_number": "718-462-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVARELLI",
        "first_name": "DANIELLE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008175-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "ZAVARELLI",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.