Individual provider Active NPI

Chana Ladaew, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1194197061
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019295-1 Issued in NY
Practice address
675 Empire Blvd Apt 6M
Brooklyn, NY 11213-5860
Phone
(718) 310-8084
NPI assigned
Oct 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019295-1 NY Primary

Addresses

Primary practice location

675 Empire Blvd Apt 6M
Brooklyn, NY 11213-5860

Mailing address

675 Empire Blvd Apt 6M
Brooklyn, NY 11213-5860
Phone (718) 310-8084

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
I20220805000196 NY Practitioner - Physician Assistant 5395127427 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019295-1NYMDPhysician Assistant

Organizations & group practices 2

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": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1194197061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 EMPIRE BLVD APT 6M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135860",
            "telephone_number": "718-310-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 EMPIRE BLVD APT 6M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135860",
            "telephone_number": "718-310-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADAEW",
        "first_name": "CHANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019295-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.