Individual provider Active NPI

Heather Sorrentino

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1437521549
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
019266 Issued in NY
Practice address
105 Haven Ave Apt 3D
New York, NY 10032-2708
Phone
(917) 822-0852
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 019266 NY Primary

Addresses

Primary practice location

105 Haven Ave Apt 3D
New York, NY 10032-2708

Mailing address

105 Haven Ave Apt 3D
New York, NY 10032-2708
Phone (917) 822-0852

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
I20190625000684 NY Practitioner - Physician Assistant 5294020442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medalliance Medical Health Services IncGroup PAC ID 4789633678, 19 clinicians

Practice addresses (Care Compare)

625 E Fordham Rd
Bronx, NY 10458-5049
Phone (718) 933-1900

National Provider Directory

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

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1437521549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HAVEN AVE APT 3D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322708",
            "telephone_number": "917-822-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HAVEN AVE APT 3D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322708",
            "telephone_number": "917-822-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRENTINO",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "019266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.