Elizabeth M Belardo, PA

Individual provider Active NPI Physician Assistant · Kingston, NY

NPI 1487325510 · NPPES record last updated Sep 28, 2021

Key facts

NPI
1487325510
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
027336 (NY)
Practice address
396 Broadway
Kingston, NY 12401-4626
Phone
(845) 334-2890
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027336 NY Yes

Addresses

Primary practice location

396 Broadway
Kingston, NY 12401-4626

Mailing address

50 Lakeview Ave
Kingston, NY 12401-4710
Phone (845) 943-0425

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2021.

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1487325510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LAKEVIEW AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014710",
            "telephone_number": "845-943-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 BROADWAY",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014626",
            "telephone_number": "845-334-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELARDO",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

All providers in Kingston, NY · Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.