Individual provider Active NPI

Waqas Ali

  • Medical Physician Assistant
  • Oceanside, NY
National Provider Identifier
1194223834
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
021756 Issued in NY
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3000
NPI assigned
Jan 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 021756 NY Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

25 Ormond St
Dix Hills, NY 11746-6331
Phone (631) 220-8073

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
I20180327001289 NY Practitioner - Physician Assistant 9436411758 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Medical Care PLLCGroup PAC ID 5698934446, 8 clinicians
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

11506 Beach Channel Dr
Suite 101
Rockaway Park, NY 11694-2113
Phone (718) 474-7744

1585 Dutch Broadway
Valley Stream, NY 11580-1333
Phone (516) 490-6300

2128 Rockaway Pkwy
Brooklyn, NY 11236-5802
Phone (718) 489-8820

23315 Hillside Ave
Queens Village, NY 11427-2634
Phone (718) 210-1945

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

3400 Boston Rd
Bronx, NY 10469-2502
Phone (718) 290-8787

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Medical Care PLLC CurrentSince Jan 31, 2026 Accepting new patients

Locations

11506 Beach Channel Dr
Ste 101
Rockaway Park, NY 11694
Phone (718) 474-7744

Organizations & group practices 4

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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1194223834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ORMOND ST",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466331",
            "telephone_number": "631-220-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "WAQAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "021756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.