Active NPI
Robert J Polintan, PA
- Physician Assistant
- New York, NY
National Provider Identifier
1336205822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 011512-1
- Practice address
- 535 E 70TH St
New York, NY 10021-4823 - Phone
- (212) 774-7111
- Fax
- (212) 774-2554
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 011512-1 | NY | Primary |
Addresses
Primary practice location
535 E 70TH St
New York, NY 10021-4823
Mailing address
8630 Chelsea St
Jamaica, NY 11432-2437
Phone (718) 657-3967
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011512 | NY | MD | Massage Therapist |
| 011512-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289174400000",
"number": "1336205822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8630 CHELSEA ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114322437",
"telephone_number": "718-657-3967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214823",
"telephone_number": "212-774-7111",
"fax_number": "212-774-2554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLINTAN",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2010-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "011512-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.