Active NPI
Michael Colantuono
- Physician Assistant
- Garden City, NY
National Provider Identifier
1164658340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 013210
- Practice address
- 520 Franklin Ave
Garden City, NY 11530-5806 - Phone
- (516) 279-6911
- NPI assigned
- Jun 2, 2009
- Sex
- Male
- 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 | 013210 | NY | Primary |
Addresses
Primary practice location
520 Franklin Ave
Garden City, NY 11530-5806
Mailing address
520 Franklin Ave
Garden City, NY 11530-5806
Phone (516) 279-6911
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 |
|---|---|---|---|---|
| I20170421000326 | NY | Order and Referring Only - Physician Assistant | 0648556902 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013210 | NY | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243900800000",
"number": "1164658340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 FRANKLIN AVE",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305806",
"telephone_number": "516-279-6911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 FRANKLIN AVE",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305806",
"telephone_number": "516-279-6911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLANTUONO",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-02",
"last_updated": "2009-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "013210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.