NPIMap

Individual provider Active NPI

Amy Skinner, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1508100736
Registry record updated Nov 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015429-1 Issued in NY
Practice address
3500 Nostrand Ave
Brooklyn, NY 11229-5107
Phone
(718) 769-2521
NPI assigned
Nov 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2012

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 015429-1 NY Primary

Addresses

Primary practice location

3500 Nostrand Ave
Brooklyn, NY 11229-5107

Mailing address

3500 Nostrand Ave
Brooklyn, NY 11229-5107
Phone (718) 769-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130506000089 NY Practitioner - Physician Assistant 5496992703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1133 Westchester Ave
White Plains, NY 10604-3516
Phone (203) 276-1000

535 E 70TH St
New York, NY 10021-4823
Phone (212) 774-7598

Hospital & facility affiliations

  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015429-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Apr 25, 2022 Accepting new patients
New York Society for Releif of the Ruptured and Crippled Maintaining CurrentSince Apr 25, 2022 Accepting new patients
New York Society for the Relief of Ruptured & Crippled Maintaining Past Accepting new patients

Locations

535 E 70th St
New York, NY 10021

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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 10

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": "1352505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352505600000",
    "number": "1508100736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295107",
            "telephone_number": "718-769-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295107",
            "telephone_number": "718-769-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "AMY",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-10",
        "last_updated": "2012-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015429-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.