Individual provider Active NPI

Claudia Radist, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1548370653
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004236 Issued in NY
Practice address
1660 E 14TH St
Ste 401
Brooklyn, NY 11229-1170
Phone
(718) 382-8500
Fax
(718) 382-4648
NPI assigned
Aug 30, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 004236 NY Primary

Addresses

Primary practice location

1660 E 14TH St
Ste 401
Brooklyn, NY 11229-1170

Mailing address

1660 E 14TH St
Ste 401
Brooklyn, NY 11229-1170
Phone (718) 382-8500

Other identifiers 1

IdentifierTypeStateIssuer
004236OtherNYDEPT OF ED

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
I20180823000755 NY Order and Referring Only - Physician Assistant 5294823514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004236NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology Oncology Associates of Brooklyn, LLP Past Accepting new patients
Hematology Oncology Associates of Brooklyn, LLP PastSince Jun 14, 1999 Accepting new patients
Bimc Faculty Practice Physician Assistant Past Accepting new patients
Beth Israel Medical Center Physician Assistant Past Accepting new patients
Beth Israel Medical Center Past Accepting new patients

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548370653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 E 14TH ST",
            "address_2": "STE 401",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291170",
            "telephone_number": "718-382-8500",
            "fax_number": "718-382-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 E 14TH ST",
            "address_2": "STE 401",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291170",
            "telephone_number": "718-382-8500",
            "fax_number": "718-382-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADIST",
        "first_name": "CLAUDIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF ED",
            "identifier": "004236",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.