Individual provider Active NPI

Andrew Ma, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1306291612
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
111 E 210 St
Bronx, NY 10467
Phone
(718) 200-8736
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 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 NY Primary

Addresses

Primary practice location

111 E 210 St
Bronx, NY 10467

Mailing address

111 E 210 St
Bronx, NY 10467
Phone (718) 200-8736

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
I20160715001623 NY Practitioner - Physician Assistant 0345532073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019645NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 12, 2016 Accepting new patients
Montefiore Medical Center CurrentSince May 12, 2016 Accepting new patients

Locations

2300 Westchester Ave
Bronx, NY 10462
Phone (718) 409-8000

111 E 210th St
Bronx, NY 10467

Networks

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

Organizations & group practices 2

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1306291612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210 ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-200-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210 ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-200-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.