Individual provider Active NPI

Justin Titus, PA

  • Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1316413651
Registry record updated Oct 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021610 Issued in NY
Practice address
9425 60TH Ave
Elmhurst, NY 11373-5069
Phone
(718) 760-0797
NPI assigned
Oct 14, 2018
Last updated
Oct 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2018

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 021610 NY Primary

Addresses

Primary practice location

9425 60TH Ave
Elmhurst, NY 11373-5069

Mailing address

4222 Ketcham St Apt 6a
Elmhurst, NY 11373-2367
Phone (516) 581-9947

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
I20220131001864 NY Practitioner - Physician Assistant 6406249259 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 30, 2024 Accepting new patients
New York University CurrentSince Jan 30, 2024 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1539475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539475200000",
    "number": "1316413651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 KETCHAM ST APT 6A",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113732367",
            "telephone_number": "516-581-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 60TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735069",
            "telephone_number": "718-760-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITUS",
        "first_name": "JUSTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-14",
        "last_updated": "2018-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.