Individual provider Active NPI

Bridget Rae Senkerik, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1457973190
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
462 1St Ave
New York, NY 10016-9196
Phone
(212) 562-6365
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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 Primary

Addresses

Primary practice location

462 1St Ave
New York, NY 10016-9196

Mailing address

1608 Wintercrest LN
Shorewood, IL 60404-0686

Other practice location 1

1608 Wintercrest Ln
Shorewood, IL 60404-0686
Phone (815) 207-1735

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
I20251208000202 NY Order and Referring Only - Physician Assistant 4789177791

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025779NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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, 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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1457973190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 WINTERCREST LN",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604040686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-6365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1608 Wintercrest Ln",
            "address_purpose": "LOCATION",
            "city": "Shorewood",
            "state": "IL",
            "postal_code": "604040686",
            "country_code": "US",
            "telephone_number": "815-207-1735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SENKERIK",
        "first_name": "BRIDGET",
        "middle_name": "RAE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.