Individual provider Active NPI

Nadine Bedrosian, P.A.

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1619117017
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
011534 Issued in NY
Practice address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone
(718) 250-8000
Fax
(718) 250-6722
NPI assigned
Feb 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011534 NY
Surgical Physician Assistant 363AS0400X 011534 NY Primary

Addresses

Primary practice location

121 Dekalb Ave
Brooklyn, NY 11201-5425

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

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
I20131216001004 NY Practitioner - Physician Assistant 9739316977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cindy Hoffman DO PCGroup PAC ID 6608979513, 8 clinicians

Practice addresses (Care Compare)

4 Crumwold PL
Hyde Park, NY 12538-1107
Phone (845) 229-2990

6 Amalfi Dr
Cortlandt Manor, NY 10567-7014

686 Stoneleigh Ave
Carmel, NY 10512-3931
Phone (845) 297-2957

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011534NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jan 1, 2017 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 1, 2017 Accepting new patients
Westchester Medical Center Past Accepting new patients
David S Cho, MD, PLLC Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

Organizations & group practices 5

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1619117017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8000",
            "fax_number": "718-250-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDROSIAN",
        "first_name": "NADINE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011534",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.