Edna Y Pleasant, PA-C
Individual provider Active NPI Physician Assistant · Bayshore, NY
NPI 1457578056 · NPPES record last updated May 10, 2016
Key facts
- NPI
- 1457578056
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 006843 (NY)
- Practice address
- 1766 Sunrise Hwy
Bayshore, NY 11706 - Phone
- (631) 665-8006
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160615002532 | NY | Order and Referring Only - Physician Assistant | 1052602422 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006843 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarita Dorschug D.O. P.C. | Past |
Accepting new patients | |
| Ivy Medicine, PC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 006843 | NY | Yes |
Addresses
Primary practice location
1766 Sunrise Hwy
Bayshore, NY 11706
Mailing address
652 Suffolk Ave
Ste 208
Brentwood, NY 11717-4305
Phone (631) 231-3535
Other providers in Bayshore, NY
- Andrea Rose Lubliner
- Wilma Euphrasia Matthews
- Marisa Nicole Medugno
- Roseann Nitz
- Wilda Novembre
- Marissa Cristina Povol
- Georgette Prawl
- Alla Ragozina
- RG Physical Therapy P.C.
- Leann Ridulfo
All providers in Bayshore, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.