Individual provider Active NPI

Amelia Mohabir, R.P.A.-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1356462840
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007901 Issued in NY
Practice address
150 Meserole Street
2ND Floor
Brooklyn, NY 11206
Phone
(866) 907-2308
Fax
(248) 855-5455
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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 007901 NY Primary

Addresses

Primary practice location

150 Meserole Street
2ND Floor
Brooklyn, NY 11206

Mailing address

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

Other names 1

  • Mrs. Amelia Wydrowski Other name

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
I20210902001418 NY Practitioner - Physician Assistant 0446656268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

180 Myrtle Ave
Brooklyn, NY 11201-7059
Phone (718) 650-2233

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

770 Flatbush Ave
Brooklyn, NY 11226-1902
Phone (347) 627-3988

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007901NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Susan E.Panes, D.O. P.C. Past Accepting new patients
MVC PA PLLC Past Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Networks

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

Organizations & group practices 4

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1356462840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MESEROLE STREET",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "866-907-2308",
            "fax_number": "248-855-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHABIR",
        "first_name": "AMELIA",
        "name_prefix": "Miss",
        "credential": "R.P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2021-09-13",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMELIA",
            "last_name": "WYDROWSKI",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.