Individual provider Active NPI

Adam Joseph Drucker, PA-C

  • Medical Physician Assistant
  • West Islip, NY
National Provider Identifier
1215493234
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
125 Sunrise Hwy
West Islip, NY 11795-2023
Phone
(631) 400-3430
NPI assigned
Feb 14, 2019
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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 Primary

Addresses

Primary practice location

125 Sunrise Hwy
West Islip, NY 11795-2023

Mailing address

125 Sunrise Hwy
West Islip, NY 11795-2023
Phone (631) 400-3430

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
I20210127002500 NY Practitioner - Physician Assistant 5496169765 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023872NYMDSpeech-Language Pathologist

Networks

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1215493234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SUNRISE HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952023",
            "telephone_number": "631-400-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SUNRISE HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952023",
            "telephone_number": "631-400-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUCKER",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.