Individual provider Active NPI

Eric Andrew Hubbard

  • Physician Assistant
  • Garden City, NY
National Provider Identifier
1295283851
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020113 Issued in NY
Practice address
372 Roxbury Rd S
Garden City, NY 11530-5230
Phone
(917) 399-4650
Fax
(772) 365-4650
NPI assigned
Sep 13, 2016
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020113 NY Primary

Addresses

Primary practice location

372 Roxbury Rd S
Garden City, NY 11530-5230

Mailing address

372 Roxbury Rd S
Garden City, NY 11530-5230
Phone (917) 399-4650

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
I20161118000760 NY Practitioner - Physician Assistant 3779862560 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020113NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Oct 13, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Oct 13, 2016 Accepting new patients
Mount Sinai School of Medicine Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ehubbard@montefioredirect.com
  • Direct secure messaging: erh9038@direct.nyp.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1295283851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 ROXBURY RD S",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305230",
            "telephone_number": "917-399-4650",
            "fax_number": "772-365-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 ROXBURY RD S",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305230",
            "telephone_number": "917-399-4650",
            "fax_number": "772-365-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "ERIC",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.