Alina Bhatt, PA
Individual provider Active NPI Medical Physician Assistant · West Islip, NY
NPI 1407285646 · NPPES record last updated Dec 25, 2016
Key facts
- NPI
- 1407285646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 017188-1 (NY)
- Practice address
- 1000 Montauk Hwy
West Islip, NY 11795-4927 - Phone
- (631) 376-4000
- NPI assigned
- Nov 7, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150408000682 | NY | Practitioner - Physician Assistant | 2062730823 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017188 | NY | MD | Clinical Psychologist |
| 017188-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Samaritan Hospital Medical | Current |
Accepting new patients | |
| PM Pediatrics of Mamaroneck | Past | Accepting new patients |
Locations
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Interoperability endpoints
- alina.bhatt@pmuc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 017188-1 | NY | Yes |
Addresses
Primary practice location
1000 Montauk Hwy
West Islip, NY 11795-4927
Mailing address
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-4000
Other names
- Alina Shah
NPI Registry JSON
{
"created_epoch": "1383782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482624000000",
"number": "1407285646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MONTAUK HWY",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954927",
"telephone_number": "631-376-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MONTAUK HWY",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954927",
"telephone_number": "631-376-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHATT",
"first_name": "ALINA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-07",
"last_updated": "2016-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "017188-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALINA",
"last_name": "SHAH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in West Islip, NY
- Robert J Berson
- Ekaterina Berulava
- Kelly Marie Bethune
- Philip Beuchert
- Tim Bevan
- Om Bhatt
- Michael A Bianco
- Ashleigh Bifolco
- Muhammad Bilal
- Lisa M Binetti
All providers in West Islip, NY · Medical Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.