Individual provider Active NPI

Robert Sellman, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1467427278
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0094581 Issued in NY
Practice address
100TH Street and Madison Ave
New York, NY 10029
Phone
(212) 241-0101
Fax
(212) 426-5083
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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 0094581 NY Primary

Addresses

Primary practice location

100TH Street and Madison Ave
New York, NY 10029

Mailing address

Box 1149
One Gustave Levy Place
New York, NY 10029
Phone (212) 241-0101

Other identifiers 1

IdentifierTypeStateIssuer
02781955MedicaidNY

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
I20040323001202 NY Practitioner - Physician Assistant 3274424809 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0094581NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Sep 3, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 13, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 13, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Madison Avenue Emergency Medicine PC Past Accepting new patients

Locations

300 Cadman Plz W
Fl 18
Brooklyn, NY 11201
Phone (929) 210-6000

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1879 Madison Ave
New York, NY 10035
Phone (212) 423-4000

1468 Madison Ave
#3220
New York, NY 10029

Networks

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

Organizations & group practices 10

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1467427278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 1149",
            "address_2": "ONE GUSTAVE LEVY PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-0101",
            "fax_number": "212-426-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100TH STREET AND MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-0101",
            "fax_number": "212-426-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLMAN",
        "first_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0094581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02781955",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.