Individual provider Active NPI

Betty Kui, PA-C

  • Physician Assistant
  • Nanuet, NY
National Provider Identifier
1417690231
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028536 Issued in NY
Practice address
233 W Route 59
Nanuet, NY 10954-2225
Phone
(845) 510-2200
Fax
(845) 215-5611
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 028536 NY Primary

Addresses

Primary practice location

233 W Route 59
Nanuet, NY 10954-2225

Mailing address

6313 83Rd PL
Middle Village, NY 11379-1949
Phone (609) 664-6634

Other practice location 1

11120 Queens Blvd
Forest Hills, NY 11375-6303
Phone (516) 200-3545

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
I20230802000562 NY Practitioner - Physician Assistant 7719348127 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bobby Buka, M.D., P.C. Multi-Specialty CurrentSince Jun 19, 2023 Accepting new patients
Derm Specs of PA PLLC Multi-Specialty PastSince Feb 25, 2024 Accepting new patients

Locations

1027 46th Ave
Fl 1
Long Island City, NY 11101

214 Sullivan St
New York, NY 10012

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

Organizations & group practices 3

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": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1417690231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6313 83RD PL",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791949",
            "telephone_number": "609-664-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 W ROUTE 59",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542225",
            "telephone_number": "845-510-2200",
            "fax_number": "845-215-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11120 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113756303",
            "country_code": "US",
            "telephone_number": "516-200-3545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUI",
        "first_name": "BETTY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

Verify at the official NPI Registry.