Individual provider Active NPI

Gary Gerard Maida, P.A.

  • Medical Physician Assistant
  • Staten Island, NY
National Provider Identifier
1487629242
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001167 Issued in NY
Practice address
4982 Hylan Blvd
Staten Island, NY 10312-6399
Phone
(718) 967-6200
Fax
(718) 967-6314
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001167 NY Primary

Addresses

Primary practice location

4982 Hylan Blvd
Staten Island, NY 10312-6399

Mailing address

414 Saint George Rd
Staten Island, NY 10306-1524
Phone (718) 967-6200

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001167NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center - MMC Emergency Physicians FPP Past Accepting new patients
Premier Pediatrics of New York, PC Past Accepting new patients

Organizations & group practices 2

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487629242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 SAINT GEORGE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061524",
            "telephone_number": "718-967-6200",
            "fax_number": "718-967-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4982 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126399",
            "telephone_number": "718-967-6200",
            "fax_number": "718-967-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIDA",
        "first_name": "GARY",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "001167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.