Individual provider Active NPI

Annette Peoples, RPA-C

  • Physician Assistant
  • New Hyde Park, NY
National Provider Identifier
1366678732
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005624 Issued in NY
Practice address
450 Lakeville Rd
New Hyde Park, NY 11042-1118
Phone
(516) 734-8730
NPI assigned
May 30, 2009
Last updated
Jul 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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 005624 NY Primary

Addresses

Primary practice location

450 Lakeville Rd
New Hyde Park, NY 11042-1118

Mailing address

642 E 59TH St
Brooklyn, NY 11234-1302
Phone (718) 209-0102

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
I20121012000018 NY Practitioner - Physician Assistant 6103075809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.07 of 100Reported as group
Quality
57.91
Promoting interoperability
77
Improvement activities
40
Cost
80.36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St John's Medical Services PC CurrentSince Jan 10, 2026 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 2, 2017 Accepting new patients
Bimc Faculty Practice Physician Assistant Past Accepting new patients

Locations

1909 Plainview Ave
Far Rockaway, NY 11691
Phone (718) 869-7690

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

9525 Queens Blvd
Ste B
Rego Park, NY 11374
Phone (718) 925-6200

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: annette.peoples.1@14448.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1366678732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 E 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112341302",
            "telephone_number": "718-209-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421118",
            "telephone_number": "516-734-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEOPLES",
        "first_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-30",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.