Individual provider Active NPI

Brandon Michael Papeika, PA-C

  • Physician Assistant
  • Roslyn, NY
National Provider Identifier
1366908725
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone
(516) 562-6000
NPI assigned
Feb 11, 2019
Last updated
Feb 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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 NU Primary

Addresses

Primary practice location

100 Port Washington Blvd
Roslyn, NY 11576-1347

Mailing address

404 Martin Ave
Maple Shade, NJ 08052-2831
Phone (856) 630-9623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190402001968 NY Practitioner - Physician Assistant 0941541841 Reassigns benefits to 2 organizations
I20191219001696 NJ Practitioner - Physician Assistant 0941541841 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX Paramus, LLCGroup PAC ID 2466589585, 63 clinicians
Prohealth Urgent Care Medicine of New Jersey LLPGroup PAC ID 6002178647, 9 clinicians

Practice addresses (Care Compare)

1210 Route 130 N
Cinnaminson, NJ 08077-3046
Phone (856) 829-0407

2001 College Dr
Suite 11
Clementon, NJ 08021-5617
Phone (856) 566-3333

4318 Route 130
Willingboro, NJ 08046-1427
Phone (609) 871-2045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital CurrentSince Mar 19, 2019 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Mar 19, 2019 Accepting new patients
Jersey Irish Medical PastSince Oct 26, 2019 Accepting new patients

Locations

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

Interoperability endpoints

  • Direct secure messaging: bpapeika75561@direct.optum.com

Organizations & group practices 8

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1366908725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 MARTIN AVE",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080522831",
            "telephone_number": "856-630-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "516-562-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPEIKA",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.