Individual provider Active NPI

Amalia Kovoros, P.A.-C

  • Medical Physician Assistant
  • Whitestone, NY
National Provider Identifier
1306178397
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013805-1 Issued in NY
Practice address
1752 Francis Lewis Blvd
Whitestone, NY 11357-3247
Phone
(718) 746-9494
Fax
(718) 746-4963
NPI assigned
Feb 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013805-1 NY Primary

Addresses

Primary practice location

1752 Francis Lewis Blvd
Whitestone, NY 11357-3247

Mailing address

1752 Francis Lewis Blvd
Whitestone, NY 11357-3247
Phone (718) 746-9494

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
I20120904000173 NY Practitioner - Physician Assistant 6507013125 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 PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

Hospital & facility affiliations

  • Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013805-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital CurrentSince Aug 1, 2012 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Aug 1, 2012 Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

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.

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": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1306178397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 FRANCIS LEWIS BLVD",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573247",
            "telephone_number": "718-746-9494",
            "fax_number": "718-746-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 FRANCIS LEWIS BLVD",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573247",
            "telephone_number": "718-746-9494",
            "fax_number": "718-746-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVOROS",
        "first_name": "AMALIA",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013805-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

Verify at the official NPI Registry.