Individual provider Active NPI

Erik C Podszus, RPA, PHD

  • Physician Assistant
  • Hauppauge, NY
National Provider Identifier
1497003909
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002267-1 Issued in NY
Practice address
700 Veterans Hwy
Suite Cl100
Hauppauge, NY 11788-2952
Phone
(631) 257-5200
Fax
(631) 257-5201
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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 002267-1 NY Primary

Addresses

Primary practice location

700 Veterans Hwy
Suite Cl100
Hauppauge, NY 11788-2952

Mailing address

700 Veterans Hwy
Suite Cl100
Hauppauge, NY 11788-2952
Phone (631) 257-5200

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
002267-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MC MD P.C. PastSince Jul 24, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1497003909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 VETERANS HWY",
            "address_2": "SUITE CL100",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882952",
            "telephone_number": "631-257-5200",
            "fax_number": "631-257-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 VETERANS HWY",
            "address_2": "SUITE CL100",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882952",
            "telephone_number": "631-257-5200",
            "fax_number": "631-257-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODSZUS",
        "first_name": "ERIK",
        "middle_name": "C",
        "credential": "RPA, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002267-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.