Individual provider Active NPI

Ellen Graffeo, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1639513369
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003815-1 Issued in NY
Practice address
2601 Ocean Pkwy
Room 4N98
Brooklyn, NY 11235-7745
Phone
(718) 616-3780
Fax
(718) 616-3797
NPI assigned
Apr 24, 2013
Last updated
Apr 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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 003815-1 NY Primary

Addresses

Primary practice location

2601 Ocean Pkwy
Room 4N98
Brooklyn, NY 11235-7745

Mailing address

2601 Ocean Pkwy
Room 4N98
Brooklyn, NY 11235-7745
Phone (718) 616-3780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003815-1NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1639513369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "address_2": "ROOM 4N98",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "718-616-3780",
            "fax_number": "718-616-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "address_2": "ROOM 4N98",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "718-616-3780",
            "fax_number": "718-616-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAFFEO",
        "first_name": "ELLEN",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003815-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.