Individual provider Active NPI

Angelica Hollweg, RPA

  • Medical Physician Assistant
  • Fresh Meadows, NY
National Provider Identifier
1154448157
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
011001 Issued in NY
Practice address
176-60 Union Turnpike
Suite 360
Fresh Meadows, NY 11366-1531
Phone
(718) 460-2300
Fax
(347) 225-9930
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011001 NY
Medical Physician Assistant 363AM0700X 011001 NY Primary

Addresses

Primary practice location

176-60 Union Turnpike
Suite 360
Fresh Meadows, NY 11366-1531

Mailing address

176-60 Union Turnpike
Suite 360
Fresh Meadows, NY 11366-1531
Phone (718) 460-2300

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
I20080108000733 NY Practitioner - Physician Assistant 7416037064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347

1000 N Village Ave
Rockville Center, NY 11570-1000

2200 Northern Blvd
Greenvale, NY 11548-1219
Phone (516) 325-7310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011001NYMDMental Health Counselor

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Oct 15, 2020 Accepting new patients
CHS Physician Partners, PC CurrentSince Oct 15, 2020 Accepting new patients

Locations

27005 76th Ave
North New Hyde Pk, NY 11040

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

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

Interoperability endpoints

  • Direct secure messaging: acaramanica83499@direct-chsli.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1154448157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176-60 UNION TURNPIKE",
            "address_2": "SUITE 360",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661531",
            "telephone_number": "718-460-2300",
            "fax_number": "347-225-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176-60 UNION TURNPIKE",
            "address_2": "SUITE 360",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661531",
            "telephone_number": "718-460-2300",
            "fax_number": "347-225-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLWEG",
        "first_name": "ANGELICA",
        "name_prefix": "Ms.",
        "credential": "RPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011001",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.