Individual provider Active NPI

Bobbie Eapen, P.A.

  • Physician Assistant
  • Syosset, NY
National Provider Identifier
1326338153
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014513 Issued in NY
Practice address
221 Jericho Tpke
Syosset, NY 11791-4515
Phone
(347) 277-8207
NPI assigned
Apr 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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 014513 NY Primary

Addresses

Primary practice location

221 Jericho Tpke
Syosset, NY 11791-4515

Mailing address

2 Carol LN
Tappan, NY 10983-2127
Phone (914) 426-7862

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
I20120911000177 NY Practitioner - Physician Assistant 4880842251 Reassigns benefits to 5 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
Rye Family Practice PCGroup PAC ID 9739355165, 2 clinicians

Practice addresses (Care Compare)

127 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7000

692 W 204TH St
New York, NY 10034-3027
Phone (646) 329-6490

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014513NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 22, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Jun 22, 2012 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Southern Westchester Nephrology PLLC Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1010 Central Park Ave
Yonkers, NY 10704
Phone (914) 964-4000

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

Networks

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

Organizations & group practices 9

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1326338153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAROL LN",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109832127",
            "telephone_number": "914-426-7862",
            "fax_number": "845-215-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 JERICHO TPKE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914515",
            "telephone_number": "347-277-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAPEN",
        "first_name": "BOBBIE",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.