Individual provider Active NPI

Whitney Winnifred Phillips, PA-C

  • Physician Assistant
  • Jackson Heights, NY
National Provider Identifier
1578058574
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022004-1 Issued in NY
Practice address
40-31 82ND Street
Jackson Heights, NY 11373-1304
Phone
(929) 299-4700
Fax
(718) 943-2700
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 022004-1 NY Primary

Addresses

Primary practice location

40-31 82ND Street
Jackson Heights, NY 11373-1304

Mailing address

55 Water St FL 2
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

1991 Marcus Ave Fl 2
New Hyde Park, NY 11042-2057
Phone (516) 354-1600

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
I20200722002027 NY Practitioner - Physician Assistant 4587088687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

18005 Hillside Ave
Jamaica, NY 11432-4727
Phone (718) 526-6300

4161 Kissena Blvd
Flushing, NY 11355-3181
Phone (718) 670-6400

Merit-based Incentive Payment System (MIPS)

Final score
86.31 of 100Reported as apm
Quality
66.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022004-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Sep 23, 2024 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Sep 15, 2022 Accepting new patients
General Physician, PC Past Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

4031 82nd St
Flushing, NY 11373
Phone (718) 662-5989

18005 Hillside Ave
Jamaica, NY 11432
Phone (718) 526-6300

1991 Marcus Ave
Fl 2
New Hyde Park, NY 11042
Phone (516) 354-1600

55 Water St
Fl 2
New York, NY 10041

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: wphillips54074@direct.acpny.com

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": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1578058574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40-31 82ND STREET",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113731304",
            "telephone_number": "929-299-4700",
            "fax_number": "718-943-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Marcus Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110422057",
            "country_code": "US",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "WHITNEY",
        "middle_name": "WINNIFRED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022004-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.