Individual provider Active NPI

Pamela Fiorillo, PA

  • Medical Physician Assistant
  • Manhasset, NY
National Provider Identifier
1518264167
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
79007 Issued in NY
Practice address
1129 Northern Blvd
Suite 408
Manhasset, NY 11030
Phone
(516) 627-2121
Fax
(516) 869-3469
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 79007 NY Primary

Addresses

Primary practice location

1129 Northern Blvd
Suite 408
Manhasset, NY 11030

Mailing address

1129 Northern Blvd
Suite 408
Manhasset, NY 11030
Phone (516) 627-2121

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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014638NYMDSpeech-Language Pathologist
79007NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Ear, Nose & Throat Surgery P.C. CurrentSince Jul 9, 2016 Accepting new patients

Locations

877 Stewart Ave
Ste 25
Garden City, NY 11530
Phone (516) 222-0404

480 E Bay Dr
Long Beach, NY 11561
Phone (516) 431-0700

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1518264167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD",
            "address_2": "SUITE 408",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-627-2121",
            "fax_number": "516-869-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD",
            "address_2": "SUITE 408",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-627-2121",
            "fax_number": "516-869-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORILLO",
        "first_name": "PAMELA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "79007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.