Individual provider Active NPI

Ricardo A Zaldivar, PA

  • Medical Physician Assistant
  • Bay Shore, NY
National Provider Identifier
1548410988
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006156-1 Issued in NY
Practice address
8 Maple Ave
Bay Shore, NY 11706-8722
Phone
(631) 665-4392
Fax
(631) 665-5008
NPI assigned
Sep 23, 2008
Last updated
Sep 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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 006156-1 NY Primary

Addresses

Primary practice location

8 Maple Ave
Bay Shore, NY 11706-8722

Mailing address

8 Maple Ave
Bay Shore, NY 11706-8722
Phone (631) 665-4392

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
I20171006000721 NY Practitioner - Physician Assistant 2860767407 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006156NYMDRegistered Dietitian
006156-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients

Organizations & group practices 2

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1548410988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MAPLE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068722",
            "telephone_number": "631-665-4392",
            "fax_number": "631-665-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MAPLE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068722",
            "telephone_number": "631-665-4392",
            "fax_number": "631-665-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALDIVAR",
        "first_name": "RICARDO",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006156-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.