Individual provider Active NPI

Ordith L Coleman, P.A.-C

  • Physician Assistant
  • Bay Shore, NY
National Provider Identifier
1578649505
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0077631 Issued in NY
Practice address
37 Belford Ave
Bay Shore, NY 11706-6818
Phone
(631) 647-4269
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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 0077631 NY Primary

Addresses

Primary practice location

37 Belford Ave
Bay Shore, NY 11706-6818

Mailing address

37 Belford Ave
Bay Shore, NY 11706-6818
Phone (631) 647-4269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20141209002032 NJ Practitioner - Physician Assistant 4587888243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

97 W Pkwy
Pompton Plains, NJ 07444-1647
Phone (973) 931-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0077631NYMDPhysical Therapist

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1578649505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BELFORD AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066818",
            "telephone_number": "631-647-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BELFORD AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066818",
            "telephone_number": "631-647-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ORDITH",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0077631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.