Individual provider Active NPI

Claire Bornstein, P.A.-C.

  • Medical Physician Assistant
  • Staten Island, NY
National Provider Identifier
1285766766
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001801 Issued in NY
Practice address
59 Revere St
Staten Island, NY 10301-3415
Phone
(718) 273-3592
Fax
(718) 273-3592
NPI assigned
Mar 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00013600 NJ
Medical Physician Assistant 363AM0700X 001801 NY Primary

Addresses

Primary practice location

59 Revere St
Staten Island, NY 10301-3415

Mailing address

908 Oak Tree Ave
Ste L
South Plainfield, NJ 07080-5134
Phone (908) 757-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100504000484 NJ Practitioner - Physician Assistant 1759419278 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001801NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Lake Medical PLLC PastSince Dec 1, 2007 Accepting new patients
Heartland Medical Services, P.C. Past Accepting new patients
Heartland Psychological Services PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFDFBA/Endpoint/CFDFBA

Organizations & group practices 4

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": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1285766766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 OAK TREE AVE",
            "address_2": "STE L",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805134",
            "telephone_number": "908-757-6660",
            "fax_number": "908-757-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 REVERE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013415",
            "telephone_number": "718-273-3592",
            "fax_number": "718-273-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNSTEIN",
        "first_name": "CLAIRE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00013600",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "001801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.