Individual provider Active NPI

Kerry A Cook, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1144579517
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015947 Issued in NY
Practice address
180 Fort Washington Ave
New York, NY 10032-3722
Phone
(212) 305-8039
NPI assigned
Aug 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015947 NY
Physician Assistant 363A00000X 015947 NY Primary

Addresses

Primary practice location

180 Fort Washington Ave
New York, NY 10032-3722

Mailing address

630 W 168TH St # 4
New York, NY 10032-3725

Other practice location 1

177 Fort Washington Ave
Suite MHB-6-435
New York, NY 10032-3733
Phone (516) 946-7010

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
I20220419001556 NY Practitioner - Physician Assistant 3173910353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

161 Fort Washington Ave
New York, NY 10032-3729
Phone (212) 305-8559

180 Fort Washington Ave
New York, NY 10032-3722
Phone (212) 305-8039

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015947NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Jul 15, 2022 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Jul 15, 2022 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

180 Fort Washington Ave
New York, NY 10032
Phone (212) 305-3535

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

177 Fort Washington Ave
Ste MHB6435
New York, NY 10032
Phone (516) 946-7010

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: kec9071@direct.nyp.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1144579517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323722",
            "telephone_number": "212-305-8039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Fort Washington Ave",
            "address_2": "Suite MHB-6-435",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323733",
            "country_code": "US",
            "telephone_number": "516-946-7010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "KERRY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015947",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.