Individual provider Active NPI

Courtney Monaghan

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1497122659
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1790 Broadway FL 8
New York, NY 10019-1412
Phone
(212) 590-5580
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1790 Broadway FL 8
New York, NY 10019-1412

Mailing address

727 Monroe St Apt 407
Hoboken, NJ 07030-6372
Phone (862) 432-9165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151221001227 CT Practitioner - Physician Assistant 8628379492 Reassigns benefits to 2 organizations
I20200130000871 NY Practitioner - Physician Assistant 8628379492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Plastic Surgical Group, PCGroup PAC ID 1153340054, 39 clinicians

Practice addresses (Care Compare)

999 Franklin Ave
Garden City, NY 11530-2913

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021249NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Center CurrentSince Nov 2, 2015 Accepting new patients
Greenwich Hospital CurrentSince Jun 19, 2025 Accepting new patients
South Nassau Communities Hospital Past Accepting new patients
North Shore-Lij Medical PC PastSince Jul 25, 2021 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

Networks

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

Interoperability endpoints

  • Direct secure messaging: cadams256036@nyumc.direct-ci.com
  • Direct secure messaging: cmonaghan60920@northwell.direct-ci.com
  • Direct secure messaging: cmonaghan723319@direct.ynhh.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1497122659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 MONROE ST APT 407",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306372",
            "telephone_number": "862-432-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 BROADWAY FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191412",
            "telephone_number": "212-590-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAGHAN",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "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.