Individual provider Active NPI

Aviva Baila Salomon, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1376715342
Registry record updated Mar 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012439 Issued in NY
Practice address
4901 14TH Ave
#4D
Brooklyn, NY 11219-3150
Phone
(718) 436-1827
NPI assigned
Mar 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2008

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 012439 NY Primary

Addresses

Primary practice location

4901 14TH Ave
#4D
Brooklyn, NY 11219-3150

Mailing address

4901 14TH Ave
#4D
Brooklyn, NY 11219-3150
Phone (718) 436-1827

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
I20110627000601 NY Practitioner - Physician Assistant 5395923114 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012439NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 1, 2017 Accepting new patients
New York University CurrentSince Apr 1, 2017 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jan 3, 2022 Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

6010 Bay Pkwy
Ste 902
Brooklyn, NY 11204
Phone (718) 475-1700

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

Networks

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

Organizations & group practices 5

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": "1206835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206835200000",
    "number": "1376715342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 14TH AVE",
            "address_2": "#4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193150",
            "telephone_number": "718-436-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 14TH AVE",
            "address_2": "#4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193150",
            "telephone_number": "718-436-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "AVIVA",
        "middle_name": "BAILA",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-30",
        "last_updated": "2008-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.