Active NPI
Konstantinos Panagioti Ververis, PA
- Surgical Physician Assistant
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 013461
- Practice address
- 535 E 70TH St
New York, NY 10021-4823 - Phone
- (646) 714-6785
- NPI assigned
- Aug 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 013461 | NY | Primary |
Addresses
Primary practice location
535 E 70TH St
New York, NY 10021-4823
Mailing address
535 E 70TH St
New York, NY 10021-4823
Phone (646) 714-6785
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kververis7573@direct.HSS.edu | Direct | |
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Direct | |
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ | Direct | |
| Direct Messaging Address | kververis7573@direct.HSS.edu | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190328001498 | NY | Practitioner - Physician Assistant | 0749458412 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Samaritan Medical Services PC
Practice addresses (Care Compare)
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000
Hospital & facility affiliations
- Chsli St Joseph Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013461 | NY | MD | Physical Therapist |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ny Society for the Relief of Ruptured & Crippled Maintaining | Current | Accepting new patients | |
| Friedrich Boettner, MD, P.C. | Past | Accepting new patients |
Locations
541 E 71st St
Fl 7
New York, NY 10021
Phone (212) 606-1992
541 E 71st St
Fl 6
New York, NY 10021
Phone (201) 599-8056
535 E 70th St
New York, NY 10021
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
- kververis7573@direct.hss.edu
- https://api.platform.athenahealth.com/1554/brand/1/csg/1/fhir/r4
- https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/
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.
-
- Orthopaedic Surgery Physician
- New York, NY
- NPI 1902243488
NY
-
- Adult Reconstructive Orthopaedic Surgery Physician
- New York, NY
- NPI 1326322769
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1285866038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214823",
"telephone_number": "646-714-6785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214823",
"telephone_number": "646-714-6785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERVERIS",
"first_name": "KONSTANTINOS",
"middle_name": "PANAGIOTI",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-12",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "013461",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kververis7573@direct.HSS.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "Legacy FHIR API URL",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR API URL",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kververis7573@direct.HSS.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.