Individual provider Active NPI

Stephen Friedman, PA

  • Medical Physician Assistant
  • Rockville Centre, NY
National Provider Identifier
1346381464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006200 Issued in NY
Practice address
1000 N. Village Avenue
Rockville Centre, NY 11570
Phone
(516) 705-1353
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 006200 NY Primary

Addresses

Primary practice location

1000 N. Village Avenue
Rockville Centre, NY 11570

Mailing address

P.O. Box 798
Rockville Centre, NY 11571
Phone (516) 705-1353

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
I20080625000755 NY Practitioner - Physician Assistant 5395816987 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical CurrentSince Mar 19, 2012 Accepting new patients
Good Samaritan Hospital CurrentSince Mar 19, 2012 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346381464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 798",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11571",
            "telephone_number": "516-705-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N. VILLAGE AVENUE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-705-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "STEPHEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.