Mary E Showstark, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18197 Issued in CA

Practice address

27 W 23Rd St # 33
Physician Assistant Program
New York, NY 10010-4202

Phone

(212) 463-0400

NPI assigned

Sep 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Mary Elizabeth Showstark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Centinela Freeman Emergency Medical Associates

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1962539684
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1275635369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 W 23RD ST",
            "address_2": "PHYSICIAN ASSISTANT PROGRAM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104202",
            "telephone_number": "212-463-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 W 23RD ST # 33",
            "address_2": "PHYSICIAN ASSISTANT PROGRAM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104202",
            "telephone_number": "212-463-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWSTARK",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "HI",
            "license": "AMD-284",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HI-LIC",
            "identifier": "AMD-284",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA PA-C",
            "identifier": "PA18197",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS",
            "identifier": "014709-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL",
            "identifier": "PA9102873",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SHOWSTARK",
            "middle_name": "ELIZABETH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amira Zeiad Shouman
• Richard Werth Shoup, MFT
• Alexander Noor Shoushtari, M.D.
• Roni Shouval, MD, PHD
• Kimberly Frances Showalter Lakin, M.D.
• Olivia G Shpak, RPH
• Ronald Shpata
• Ron Shpindler
• Aaron Carl Shpiner
• Regina Shpitsberg, RPH

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.