Individual provider Active NPI

Linda M Cunningham, PA-C

  • Physician Assistant
  • Carmel, NY
National Provider Identifier
1457803298
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020099-1 Issued in NY
Practice address
21 Old Route 6
Carmel, NY 10512-2107
Phone
(845) 225-5202
Fax
(845) 225-0700
NPI assigned
Oct 27, 2016
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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 020099-1 NY Primary

Addresses

Primary practice location

21 Old Route 6
Carmel, NY 10512-2107

Mailing address

79 Glenridge Rd
Glenville, NY 12302-4523

Other practice location 1

396 Broadway
Kingston, NY 12401-4626
Phone (845) 489-2826

Other practice location 2

75 Seminary Hill Rd
Carmel, NY 10512-1921
Phone (845) 225-3400

Other identifiers 1

IdentifierTypeStateIssuer
01420795MedicaidNY

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
I20161227001181 NY Practitioner - Physician Assistant 1759662109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arms Acres IncGroup PAC ID 8820980691, 5 clinicians

Practice addresses (Care Compare)

21 Old Route 6
Carmel, NY 10512-2107
Phone (845) 225-5202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020099-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arms Acres Inc CurrentSince Apr 1, 2017 Accepting new patients
Arms Acres Inc CurrentSince Apr 1, 2017 Accepting new patients
Arms Acres Inc Past Accepting new patients

Locations

3584 Jerome Ave
Bronx, NY 10467
Phone (718) 231-4443

21 Old Route 6
Carmel, NY 10512
Phone (845) 225-5202

75 Seminary Hill Rd
Carmel, NY 10512
Phone (800) 989-2676

9002 161st St
Jamaica, NY 11432
Phone (718) 520-1513

79 Glenridge Rd
Scotia, NY 12302
Phone (518) 952-8142

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": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1457803298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 GLENRIDGE RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 OLD ROUTE 6",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122107",
            "telephone_number": "845-225-5202",
            "fax_number": "845-225-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "396 Broadway",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124014626",
            "country_code": "US",
            "telephone_number": "845-489-2826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Seminary Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105121921",
            "country_code": "US",
            "telephone_number": "845-225-3400",
            "fax_number": "845-704-6182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LINDA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020099-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.