Individual provider Active NPI

Emma Justine Poulshock, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1447959564
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030944 Issued in NY
Practice address
332 E 14TH St
New York, NY 10003-4243
Phone
(212) 481-3333
Fax
(212) 253-4242
NPI assigned
Feb 27, 2023
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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 030944 NY Primary

Addresses

Primary practice location

332 E 14TH St
New York, NY 10003-4243

Mailing address

332 E 14TH St
New York, NY 10003-4243
Phone (212) 481-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20240103004293 NY Practitioner - Physician Assistant 1658722673 Reassigns benefits to 2 organizations
I20250912000832 NJ Practitioner - Physician Assistant 1658722673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Family Medicine PLLCGroup PAC ID 1456879451, 23 clinicians

Practice addresses (Care Compare)

300 W 108TH St
New York, NY 10025-2788
Phone (212) 280-4740

535 W 110TH St
Apt 1E
New York, NY 10025-2021
Phone (212) 280-4740

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Past Accepting new patients
American Chiropractic Enterprise PLLC Past Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1447959564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034243",
            "telephone_number": "212-481-3333",
            "fax_number": "212-253-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 E 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034243",
            "telephone_number": "212-481-3333",
            "fax_number": "212-253-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSHOCK",
        "first_name": "EMMA",
        "middle_name": "JUSTINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.