Individual provider Active NPI

Ebonick Antoinette McAllister

  • Case Manager/Care Coordinator
  • Far Rockaway, NY
National Provider Identifier
1376274217
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2517 Brookhaven Ave
Far Rockaway, NY 11691-2016
Phone
(347) 468-2900
NPI assigned
Jun 21, 2022
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

2517 Brookhaven Ave
Far Rockaway, NY 11691-2016

Mailing address

2517 Brookhaven Ave
Far Rockaway, NY 11691-2016
Phone (347) 468-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1376274217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 BROOKHAVEN AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912016",
            "telephone_number": "347-468-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 BROOKHAVEN AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912016",
            "telephone_number": "347-468-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALLISTER",
        "first_name": "EBONICK",
        "middle_name": "ANTOINETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.