Individual provider Active NPI

Amy Elisabeth Pearsall, PA-C

  • Physician Assistant
  • West Islip, NY
National Provider Identifier
1235648999
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone
(631) 376-4444
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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 Primary

Addresses

Primary practice location

1000 Montauk Hwy
West Islip, NY 11795-4927

Mailing address

73 Bayside Ave
Amityville, NY 11701-3652
Phone (516) 509-5071

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
I20171213002962 NY Practitioner - Physician Assistant 9133487408 Reassigns benefits to 6 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

Practice addresses (Care Compare)

1757 Sunrise Hwy
Bay Shore, NY 11706-6014

1850 Sunrise Hwy
Bay Shore, NY 11706-6012
Phone (631) 581-5900

1930 Deer Park Ave
Deer Park, NY 11729-3328
Phone (631) 254-5900

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

5600 Sunrise Hwy
Sayville, NY 11782-1017
Phone (631) 563-7828

656 Wellwood Ave
N
Lindenhurst, NY 11757-1695
Phone (631) 225-4227

901 Sunrise Hwy
Copiague, NY 11726-1300
Phone (631) 841-5900

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side PLLC CurrentSince Oct 1, 2020 Accepting new patients
Mercy Medical Center CurrentSince Jun 9, 2018 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Nov 4, 2017 Accepting new patients
Mercy Medical Center CurrentSince Jun 9, 2018 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Interoperability endpoints

  • Direct secure messaging: amy.pearsall.1@2983.direct.athenahealth.com

Organizations & group practices 10

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1235648999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 BAYSIDE AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013652",
            "telephone_number": "516-509-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSALL",
        "first_name": "AMY",
        "middle_name": "ELISABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "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.