Individual provider Active NPI

Courtney Maureen Loftus, PA-C, ATC

  • Physician Assistant
  • New York, NY
National Provider Identifier
1508245366
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022970 Issued in NY
Practice address
176 3Rd Ave
New York, NY 10003-2520
Phone
(800) 321-9999
NPI assigned
May 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT005682 PA
Physician Assistant 363A00000X
Physician Assistant 363A00000X 1146529 NY
Physician Assistant 363A00000X 022970 NY Primary

Addresses

Primary practice location

176 3Rd Ave
New York, NY 10003-2520

Mailing address

925 Chestnut St FL 5
Philadelphia, PA 19107-4290

Other practice location 1

33rd and Market
Daskalakis Athletic Center
Philadelphia, PA 19104
Phone (856) 404-7219

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL http://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)
FHIR URL http://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address JOY9073@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190104001623 NY Practitioner - Physician Assistant 2466798939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

16 TH St and 1St Ave
New York, NY 10003-3804
Phone (212) 420-2000

301 E 17TH St
New York, NY 10003-3804
Phone (212) 263-7300

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RT005682PAMDAthletic Trainer
022970NYMDSpeech-Language Pathologist
1146529NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Nov 25, 2022 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Nov 25, 2022 Accepting new patients
New York University CurrentSince Aug 1, 2025 Accepting new patients
New York University CurrentSince Aug 1, 2025 Accepting new patients
Rothman Orthopaedics of New York, PLLC CurrentSince Oct 22, 2018 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

590 5th Ave
Fl 5
New York, NY 10036
Phone (212) 305-4878

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

176 3rd Ave
New York, NY 10003
Phone (646) 437-8899

622 W 168th St
Ph 11
New York, NY 10032
Phone (212) 305-5976

658 White Plains Rd
Tarrytown, NY 10591
Phone (888) 636-7840

Networks

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

Interoperability endpoints

  • Direct secure messaging: cloftus482060@nyumc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: joy9073@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 7

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1508245366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST FL 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032520",
            "telephone_number": "800-321-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33rd and Market",
            "address_2": "Daskalakis Athletic Center",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "856-404-7219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOFTUS",
        "first_name": "COURTNEY",
        "middle_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT005682",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1146529",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "http://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "622 West 168th Street",
            "address_2": "PH 11",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "http://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "590 5th Avenue",
            "address_2": "5th Floor",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JOY9073@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Access",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "622 West 168th Street",
            "address_2": "PH 11",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.