Individual provider Active NPI

Emily Moss, PA-C

  • Surgical Physician Assistant
  • Islandia, NY
National Provider Identifier
1619640943
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
026926 Issued in NY
Practice address
1345 Motor Pkwy FL 1
Islandia, NY 11749-5208
Phone
(516) 616-5500
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 026926 NY Primary

Addresses

Primary practice location

1345 Motor Pkwy FL 1
Islandia, NY 11749-5208

Mailing address

125 Mineola Ave Ste 200
Roslyn Heights, NY 11577-2042

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

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
I20211111001232 NY Practitioner - Physician Assistant 5395134423 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Bariatric Surgery Group PLLCGroup PAC ID 4981045432, 39 clinicians
St Charles Hospital CorpGroup PAC ID 6103733050, 62 clinicians

Practice addresses (Care Compare)

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2042
Phone (516) 616-5500

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026926NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center Single Specialty CurrentSince Nov 4, 2021 Accepting new patients
CHS Physician Partners, P.C Single Specialty CurrentSince Nov 4, 2021 Accepting new patients
CHS Physician Partners, PC Single Specialty CurrentSince Nov 4, 2021 Accepting new patients
Mercy Medical Center Single Specialty CurrentSince Nov 4, 2021 Accepting new patients
St Charles Hospital Corp Single Specialty CurrentSince Sep 27, 2025 Accepting new patients
Nrad Medical Associates, PC Single Specialty Past Accepting new patients
Bethpage Medical, PLLC Single Specialty Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

16303 Horace Harding Expy
Ste 100
Fresh Meadows, NY 11365
Phone (718) 454-4600

55 Medford Ave
Unit D
Patchogue, NY 11772
Phone (631) 475-3020

300 Community Dr
Plandome, NY 11030

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

Networks

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

Interoperability endpoints

  • Direct secure messaging: emeyer69594@northwell.direct-ci.com
  • Direct secure messaging: nybg.emilymoss@136202.advancedmd-direct.com

Organizations & group practices 12

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1619640943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MINEOLA AVE STE 200",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 MOTOR PKWY FL 1",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495208",
            "telephone_number": "516-616-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "026926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Islandia, NY

Sources for this page

Verify at the official NPI Registry.