Individual provider Active NPI

Stephanos Eleftheriadis

  • Surgical Physician Assistant
  • Bronx, NY
National Provider Identifier
1194463083
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
600 E 233Rd St
Bronx, NY 10466-2604
Phone
(718) 920-9065
NPI assigned
May 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

600 E 233Rd St
Bronx, NY 10466-2604

Mailing address

PO Box 90291
Brooklyn, NY 11209-0291

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
I20221116002190 NY Practitioner - Physician Assistant 5890163224 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Sep 1, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

4141 Carpenter Ave
Fl 4
Bronx, NY 10466
Phone (718) 920-9320

1250 Waters Pl
Ste 903
Bronx, NY 10461
Phone (718) 450-9955

75 E Gun Hill Rd
Bronx, NY 10467
Phone (718) 655-1313

1250 Waters Pl
Fl 11
Bronx, NY 10461
Phone (347) 577-4460

555 Taxter Rd
Elmsford, NY 10523
Phone (718) 920-2587

Networks

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

Interoperability endpoints

  • Direct secure messaging: seleftheri@montefioredirect.com

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": "1653177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1194463083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90291",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112090291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEFTHERIADIS",
        "first_name": "STEPHANOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-22",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.