Individual provider Active NPI

Catherine Migliaccio, PA

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1346547999
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
014407-01 Issued in NY
Practice address
3959 Broadway FL 2
New York, NY 10032-1559
Phone
(212) 342-8585
Fax
(877) 316-5152
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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 014407-01 NY Primary

Addresses

Primary practice location

3959 Broadway FL 2
New York, NY 10032-1559

Mailing address

881 Putnam Ave
Merrick, NY 11566-1213

Other practice location 1

1129 Northern Blvd
Suite 408
Manhasset, NY 11030
Phone (516) 627-2121

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
I20240117003326 NY Practitioner - Physician Assistant 8729430541 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014407NYMDMental Health Counselor
014407-01NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 2, 2024 Accepting new patients
New York University CurrentSince Jan 2, 2024 Accepting new patients

Locations

1129 Northern Blvd
Ste 408
Manhasset, NY 11030
Phone (516) 627-2121

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

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: cmigliaccio617766@nyumc.direct-ci.com

Organizations & group practices 2

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1346547999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 PUTNAM AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-342-8585",
            "fax_number": "877-316-5152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 Northern Blvd",
            "address_2": "Suite 408",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "11030",
            "country_code": "US",
            "telephone_number": "516-627-2121",
            "fax_number": "516-869-3469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIGLIACCIO",
        "first_name": "CATHERINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014407-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.