Individual provider Active NPI

Louis I Schwartz

  • Physician Assistant
  • Far Rockaway, NY
National Provider Identifier
1609532456
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030459 Issued in NY
Practice address
919 Cornaga Ave
Far Rockaway, NY 11691-5017
Phone
(443) 869-0967
NPI assigned
Nov 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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 030459 NY Primary

Addresses

Primary practice location

919 Cornaga Ave
Far Rockaway, NY 11691-5017

Mailing address

919 Cornaga Ave
Far Rockaway, NY 11691-5017

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
I20231107002596 NY Practitioner - Physician Assistant 0042667487 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030459NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC CurrentSince Sep 16, 2023 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

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

Organizations & group practices 3

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1609532456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CORNAGA AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CORNAGA AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915017",
            "telephone_number": "443-869-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "LOUIS",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.