Individual provider Active NPI

Steven Jankowski, PA-C

  • Physician Assistant
  • Patchogue, NY
National Provider Identifier
1649712688
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020400 Issued in NY
Practice address
101 Hospital Rd
Patchogue, NY 11772-4870
Phone
(631) 398-3865
NPI assigned
Nov 8, 2016
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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 020400 NY Primary

Addresses

Primary practice location

101 Hospital Rd
Patchogue, NY 11772-4870

Mailing address

755 Greenbelt Pkwy W
Holbrook, NY 11741-4207

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
I20170404000086 NY Practitioner - Physician Assistant 2466738570 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Association of New York PCGroup PAC ID 8426952813, 35 clinicians

Practice addresses (Care Compare)

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 9, 2018 Accepting new patients
Emergency Medicine Physicians of Suffolk County, PLLC Past Accepting new patients

Locations

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

300 Community Dr
Manhasset, NY 11030

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1649712688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 GREENBELT PKWY W",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-398-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKOWSKI",
        "first_name": "STEVEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.