Active NPI
Candice A. Waith
- Physician Assistant
- Bronx, NY
National Provider Identifier
1144466947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 013092
- Practice address
- Third Avenue and 183Rd Street
Bronx, NY 10457-2594 - Phone
- (718) 960-9000
- NPI assigned
- Dec 29, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 013092 | NY | Primary |
Addresses
Primary practice location
Third Avenue and 183Rd Street
Bronx, NY 10457-2594
Mailing address
183Rd & Third Ave
Bronx, NY 11413-2006
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 |
|---|---|---|---|---|
| I20180208000356 | NY | Order and Referring Only - Physician Assistant | 0244590420 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013092 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1144466947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "183RD & THIRD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "114132006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "THIRD AVENUE AND 183RD STREET",
"city": "BRONX",
"state": "NY",
"postal_code": "104572594",
"telephone_number": "718-960-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITH",
"first_name": "CANDICE",
"middle_name": "A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "013092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.