Epic Medical Associates LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

EPIC MEDICAL ASSOCIATES LLC

Practice address

145 Orinoco Dr
Suite 614
Brightwaters, NY 11718-3024

Phone

(631) 526-9305

Fax

(631) 526-9306

NPI assigned

Dec 14, 2015

Last updated

Dec 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charise Y Guadarrama, PA

Title

President/Owner

Phone

(631) 526-9305

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1285009464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 614",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117180614",
            "telephone_number": "631-526-9305",
            "fax_number": "631-526-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 ORINOCO DR",
            "address_2": "SUITE 614",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117183024",
            "telephone_number": "631-526-9305",
            "fax_number": "631-526-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "GUADARRAMA",
        "authorized_official_first_name": "CHARISE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "631-526-9305",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Delvecchio, OTR
• Jessica Dezego, PA-C
• Eric John Dieckmann
• Jessica Dufour Rosado
• Tashina Elizabeth Dussie, D.O
• Janet B Erickson, M.D.
• Nicole Lynn Flandina, FNP-C
• Eric C Freeman, D.O.
• Isabella Rose Giordano
• Nicole Grehn, AGPCNP-C

• Physician Assistant in Brightwaters, NY
• Providers in Brightwaters, 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 Dec 14, 2015; 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.