Heather Marie Prussen, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016089 Issued in NY

Practice address

200 Garden City PLZ
Garden City, NY 11530-3301

Phone

(516) 663-6400

NPI assigned

Oct 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Kumar Medical Pain Management PCGroup PAC ID 5294145249, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Kumar Medical Pain Management PC

  • Physical Medicine & Rehabilitation Physician
  • Plainview, NY
  • NPI 1417575911
  Medicare reassignment Care Compare group NPD
• Bethpage Medical, PLLC

  • Obstetrics & Gynecology Physician
  • Garden City, NY
  • NPI 1205074739
  Medicare reassignment

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1164775656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 THOMAS ST",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115662652",
            "telephone_number": "516-458-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GARDEN CITY PLZ",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303301",
            "telephone_number": "516-663-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSSEN",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-21",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Profile Physical Therapy & Wellness
• Prohealth Dental PLLC
• Timothy William Prohinsie, MS, ATC
• Prophase Diagnostics Ny, Inc
• Jessica Prudencio, PMHNP-BC
• Psychological Diagnostic Evaluations of New York
• Dina Marie Puglissi, RPAC
• Heather Puleo, PA
• Sapna Punj, DDS
• William A. Purtill, M.D.

• Physician Assistant in Garden City, NY
• Providers in Garden City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.