Meredith Alice McCourt, PA
Individual provider Active NPI Physician Assistant · Mineola, NY
NPI 1558035014 · NPPES record last updated Nov 2, 2023
Key facts
- NPI
- 1558035014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 028230-01 (NY)
- Practice address
- 259 1St St
Mineola, NY 11501-3957 - Phone
- (516) 663-0333
- NPI assigned
- Aug 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220324002141 | CT | Practitioner - Physician Assistant | 4688069826 | |
| I20240229001332 | NY | Practitioner - Physician Assistant | 4688069826 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028230 | NY | MD | Physical Therapist |
| 028230-01 | NY | MD | Physician Assistant |
| 5494 | CT | MD | Surgical Physician Assistant |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current |
Accepting new patients | |
| New York University | Surgery | Current |
Accepting new patients |
Locations
259 1st St
Mineola, NY 11501
Phone (516) 576-1820
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 028230-01 | NY | Yes |
| Surgical Physician Assistant | 363AS0400X | 5494 | CT |
Addresses
Primary practice location
259 1St St
Mineola, NY 11501-3957
Mailing address
73 Cove Rd
Huntington, NY 11743-2254
Phone (516) 446-9843
Other practice location 1
34 Maple St
Norwalk, CT 06850-3815
Phone (203) 852-2000
Other providers in Mineola, NY
- Chiquia Monique Mayhew
- Cynthia Mazer
- Joseph Patrick Mazzie
- Spencer Thomas Mazzilli
- Gary W McCall
- Edward McDonnell
- Terrence McDonough
- Brendan M McElroy
- Seamus McEntee
- Ingrid McFarlane
All providers in Mineola, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.