Individual provider Active NPI

Julie Minnisch, MS

  • Physician Assistant
  • Long Beach, NY
National Provider Identifier
1417695404
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
904 W Beech St
Long Beach, NY 11561-1429
Phone
(516) 272-4353
NPI assigned
May 20, 2022
Last updated
Dec 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 NU Primary

Addresses

Primary practice location

904 W Beech St
Long Beach, NY 11561-1429

Mailing address

904 W Beech St
Long Beach, NY 11561-1429
Phone (516) 272-4353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221103000513 NJ Practitioner - Physician Assistant 4082081039 Reassigns benefits to 2 organizations
I20240201004170 NY Practitioner - Physician Assistant 4082081039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1989 Merrick Rd
Merrick, NY 11566-4643
Phone (516) 584-4448

235 Glen Cove Rd
Carle Place, NY 11514-1221
Phone (516) 877-2273

30 Franklin Ave
Franklin Square, NY 11010-2527
Phone (516) 352-0253

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

4410 Sunrise Hwy
Massapequa, NY 11758-5346
Phone (516) 998-1024

560 Merrick Rd
Rockville Centre, NY 11570-5445
Phone (516) 858-2373

585 Merrick Rd
Lynbrook, NY 11563-2311
Phone (516) 764-2273

904 W Beech St
Long Beach, NY 11561-1429
Phone (516) 272-4353

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jan 18, 2024 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jan 18, 2024 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

904 W Beech St
Long Beach, NY 11561
Phone (516) 272-4353

1345 Avenue of the Americas
Fl 8
New York, NY 10105
Phone (212) 913-0828

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: julie.minnisch.1@2983.direct.athenahealth.com

Organizations & group practices 5

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": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1417695404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W BEECH ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611429",
            "telephone_number": "516-272-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W BEECH ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611429",
            "telephone_number": "516-272-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNISCH",
        "first_name": "JULIE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.