Active NPI
Yonette R Hercules, PA
- Medical Physician Assistant
- New York, NY
National Provider Identifier
1518007152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 009255-1
- Practice address
- One Penn Plaza, 7TH FL, Suite 725
New York, NY 10119 - Phone
- (718) 712-5308
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 009255-1 | NY | Primary |
Addresses
Primary practice location
One Penn Plaza, 7TH FL, Suite 725
New York, NY 10119
Mailing address
14603 221St St
Springfield Gardens, NY 11413-3834
Phone (718) 712-5308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009255-1 | NY | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400544000000",
"number": "1518007152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14603 221ST ST",
"city": "SPRINGFIELD GARDENS",
"state": "NY",
"postal_code": "114133834",
"telephone_number": "718-712-5308",
"fax_number": "718-785-5728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE PENN PLAZA, 7TH FL, SUITE 725",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10119",
"telephone_number": "718-712-5308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERCULES",
"first_name": "YONETTE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2014-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "009255-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.