Stephen John Kingston II, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

008910 Issued in NY

Practice address

Route 96
Romulus, NY 14541-0400

Phone

(607) 869-5111

NPI assigned

Mar 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

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

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.

• Vikas Desai MD PC

  • Internal Medicine Physician
  • East Islip, NY
  • NPI 1407096282
  Medicare reassignment

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1316064124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 PENFIELD RD",
            "address_2": "APT 85",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262148",
            "telephone_number": "585-264-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 96",
            "city": "ROMULUS",
            "state": "NY",
            "postal_code": "145410400",
            "telephone_number": "607-869-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSTON",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon E. Gullo, PEDIATRIC NURSE PRAC
• David L Haimes, PA
• Katrina Ann Harris-Maxwell, LCSW
• Farah Hussain, M.D.
• Krista Fayre Johnson
• Rene Adele Mitchell
• Lisa J. Pappa, PMH-NP
• Susan M Petersen, RDN
• Catoria Querrie, FNP
• Angela Catherine Riddle

• Medical Physician Assistant in Romulus, NY
• Providers in Romulus, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.