Individual provider Active NPI

Moran Cohen

  • Physician Assistant
  • Great Neck, NY
National Provider Identifier
1235741919
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026165 Issued in NY
Practice address
30 Ridge Dr E
Great Neck, NY 11021-2839
Phone
(516) 265-6580
NPI assigned
Aug 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 026165 NY Primary

Addresses

Primary practice location

30 Ridge Dr E
Great Neck, NY 11021-2839

Mailing address

30 Ridge Dr E
Great Neck, NY 11021-2839
Phone (516) 265-6580

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
I20210121002742 NY Practitioner - Physician Assistant 8123432721 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Plastic Surgery PC CurrentSince Nov 9, 2025 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. PastSince Nov 9, 2025 Accepting new patients

Locations

833 Northern Blvd
Ste 160
Great Neck, NY 11021
Phone (516) 498-8400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1235741919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 RIDGE DR E",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212839",
            "telephone_number": "516-265-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 RIDGE DR E",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212839",
            "telephone_number": "516-265-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MORAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-23",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.