Angenie Preval, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4396 Issued in MA

Practice address

2510 30TH Ave
Long Island City, NY 11102-2448

Phone

(718) 932-7151

NPI assigned

Aug 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: anp9136@direct.nyp.org

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.

• Fpa Hospital Based

  • Nuclear Medicine Physician
  • New York, NY
  • NPI 1629319413
  Medicare reassignment
• Fpa Hospital Based

  • Dermatopathology (Pathology) Physician
  • New York, NY
  • NPI 1841531795
  NPD

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1376891564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COLSON WAY",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682752",
            "telephone_number": "857-991-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-932-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVAL",
        "first_name": "ANGENIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maurizio Sergio Prainito
• Soumya Prajeesh, M.A.S.L.P
• Rajiv Prasad, M.D.
• Raazia N Prashad
• Elissa Presner, P.A.-C
• Rashad Janee Previllon, PMHNP-BC
• Prime Health Inc
• Prime Time Transportation
• Prime Time Transportation, Inc.
• Laura Marie Primis, MS CCC-SLP

• Physician Assistant in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.