Individual provider Active NPI

James Christian Sardelli, RPA-C

  • Physician Assistant
  • Great Neck, NY
National Provider Identifier
1396026779
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012458 Issued in NY
Practice address
15 Barstow Rd
Suite 105
Great Neck, NY 11021-2211
Phone
(516) 467-0510
NPI assigned
Aug 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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 012458 NY Primary

Addresses

Primary practice location

15 Barstow Rd
Suite 105
Great Neck, NY 11021-2211

Mailing address

15 Barstow Rd
Suite 105
Great Neck, NY 11021-2211
Phone (516) 467-0510

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

State licenses

LicenseStateTypeSpecialty
012458NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1396026779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BARSTOW RD",
            "address_2": "SUITE 105",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212211",
            "telephone_number": "516-467-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BARSTOW RD",
            "address_2": "SUITE 105",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212211",
            "telephone_number": "516-467-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDELLI",
        "first_name": "JAMES",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.