Individual provider Active NPI

Colleen Woodley, PA

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1528119229
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008086 Issued in NY
Practice address
8900 Van Wyck Expy
JHMC ER
Jamaica, NY 11418-2897
Phone
(718) 206-6000
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 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 008086 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
JHMC ER
Jamaica, NY 11418-2897

Mailing address

80 Marcus Dr
Melville, NY 11747-4230
Phone (631) 391-7700

Other identifiers 1

IdentifierTypeStateIssuer
02239132MedicaidNY

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
I20080430000406 NY Practitioner - Physician Assistant 6608955786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008086NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Mar 13, 2018 Accepting new patients
Jamaica Hospital CurrentSince Mar 13, 2018 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 10, 2017 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

300 Community Dr
Plandome, NY 11030

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 4

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1528119229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-7700",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "address_2": "JHMC ER",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODLEY",
        "first_name": "COLLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02239132",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.