Madaline Ash, R-PAC
Individual provider Active NPI Medical Physician Assistant · Bethpage, NY
NPI 1235494451 · NPPES record last updated Feb 17, 2022
Key facts
- NPI
- 1235494451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 015610 (NY)
- Practice address
- 4295 Hempstead Tpke
Bethpage, NY 11714-5713 - Phone
- (516) 579-6000
- NPI assigned
- Jul 13, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121126000643 | NY | Practitioner - Physician Assistant | 2466603386 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015610 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 015610 | NY | |
| Medical Physician Assistant | 363AM0700X | 015610 | NY | Yes |
Addresses
Primary practice location
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Mailing address
1205 Franklin Ave
Garden City, NY 11530-1629
Phone (516) 222-0067
Other providers in Bethpage, NY
- Anthony Arcati
- Robert Arcati
- Susanatte Archer
- Jose Alex Arevalo
- Ari Gitlin DDS PC
- Dennis Mitchell Ashford
- Shari Ashkin
- Mansoor Ashraf
- Uzma Aslam
- Vijaya Lakshmi Atluru
All providers in Bethpage, NY · Medical Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.