Individual provider Active NPI

James Frank Bavaro I, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1386367977
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
118040-01 Issued in NY
Practice address
3333 Hylan Blvd
Staten Island, NY 10306-3608
Phone
(718) 667-7500
Fax
(718) 667-0391
NPI assigned
Sep 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 118040-01 NY Primary

Addresses

Primary practice location

3333 Hylan Blvd
Staten Island, NY 10306-3608

Mailing address

142 Shiel Ave
Staten Island, NY 10309-4280
Phone (718) 689-2975

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
I20230410001156 NY Practitioner - Physician Assistant 8527433325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

3333 Hylan Blvd
Staten Island, NY 10306-3608
Phone (516) 302-8180

36 Lincoln Ave
Rockville Centre, NY 11570-5768
Phone (516) 536-2800

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118040-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC CurrentSince Jan 27, 2023 Accepting new patients
True North Medical Group PC Physician Assistant CurrentSince Jan 27, 2023 Accepting new patients

Locations

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

3333 Hylan Blvd
Staten Island, NY 10306
Phone (718) 667-3333

Networks

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

Organizations & group practices 2

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1386367977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SHIEL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103094280",
            "telephone_number": "718-689-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063608",
            "telephone_number": "718-667-7500",
            "fax_number": "718-667-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVARO",
        "first_name": "JAMES",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "118040-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.