Individual provider Active NPI

Luke Renda

  • Physician Assistant
  • Garden City, NY
National Provider Identifier
1396629317
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
400 Garden City PLZ
Garden City, NY 11530-3322
Phone
(516) 246-8800
NPI assigned
Aug 4, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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 Primary

Addresses

Primary practice location

400 Garden City PLZ
Garden City, NY 11530-3322

Mailing address

400 Garden City PLZ
Garden City, NY 11530-3322
Phone (516) 246-8800

Other practice location 1

175 Jericho Tpke
Syosset, NY 11791-4532
Phone (516) 246-8800

Other practice location 2

25173 Jericho Tpke
Bellerose, NY 11426-2209
Phone (516) 246-8800

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

Practice roles

OrganizationSpecialtyStatusNew patients
NS Arora Dermatology PLLC PastSince Jul 17, 2023 Accepting new patients

Organizations & group practices 1

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": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1396629317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GARDEN CITY PLZ",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303322",
            "telephone_number": "516-246-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GARDEN CITY PLZ",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303322",
            "telephone_number": "516-246-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Jericho Tpke",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "117914532",
            "country_code": "US",
            "telephone_number": "516-246-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25173 Jericho Tpke",
            "address_purpose": "LOCATION",
            "city": "Bellerose",
            "state": "NY",
            "postal_code": "114262209",
            "country_code": "US",
            "telephone_number": "516-246-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENDA",
        "first_name": "LUKE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.