Individual provider Active NPI

Cian Kinderman, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1548917636
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
311 W 35TH St
New York, NY 10001-1701
Phone
(212) 736-5900
NPI assigned
Mar 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 NY Primary

Addresses

Primary practice location

311 W 35TH St
New York, NY 10001-1701

Mailing address

311 W 35TH St
New York, NY 10001-1701

Other practice location 1

885 S Pitkin Ave
Superior, CO 80027-8032
Phone (303) 646-7104

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220412002094 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6709272198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028191NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1548917636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 35TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 35TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011701",
            "telephone_number": "212-736-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "885 S Pitkin Ave",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "CO",
            "postal_code": "800278032",
            "country_code": "US",
            "telephone_number": "303-646-7104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINDERMAN",
        "first_name": "CIAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.