Individual provider Active NPI

Elizabeth Ann Flanagan

  • Physician Assistant
  • Huntington, NY
National Provider Identifier
1417280967
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013490-1 Issued in NY
Practice address
196 E Main St
Huntington, NY 11743-2922
Phone
(631) 271-8030
Fax
(631) 271-8448
NPI assigned
Sep 16, 2009
Last updated
May 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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 013490-1 NY Primary

Addresses

Primary practice location

196 E Main St
Huntington, NY 11743-2922

Mailing address

196 E Main St
Huntington, NY 11743-2922
Phone (631) 271-8030

Other practice location 1

8926 Woodyard Rd
Suite 701
Clinton, MD 20735-4220
Phone (301) 856-1682

Other identifiers 1

IdentifierTypeStateIssuer
013490-1OtherNYLICENSE

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
I20100508000040 NY Practitioner - Physician Assistant 0042348229 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013490-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 10, 2019 Accepting new patients
New York Pain Consultants LLC CurrentSince Jun 1, 2020 Accepting new patients
The Central Orthopedic Group L L P CurrentSince Nov 1, 2019 Accepting new patients
Greater Metropolitan Orthopaedics Past Accepting new patients
Anthony Cappellino MD PC Past Accepting new patients

Locations

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

500 W Main St
Ste 116
Babylon, NY 11702

196 E Main St
Huntington, NY 11743
Phone (631) 271-8030

300 Community Dr
Manhasset, NY 11030

651 Old Country Rd
Plainview, NY 11803
Phone (516) 681-8822

Interoperability endpoints

  • Direct secure messaging: elizabeth.flanagan@983.chartlogic.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1417280967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432922",
            "telephone_number": "631-271-8030",
            "fax_number": "631-271-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432922",
            "telephone_number": "631-271-8030",
            "fax_number": "631-271-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8926 Woodyard Rd",
            "address_2": "Suite 701",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MD",
            "postal_code": "207354220",
            "country_code": "US",
            "telephone_number": "301-856-1682",
            "fax_number": "301-856-0964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013490-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "013490-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.