Active NPI
Radha Joshi
- Physician Assistant
- Port Jefferson, NY
National Provider Identifier
1659419679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 011582
- Practice address
- 75 N Country Rd
Port Jefferson, NY 11777-2119 - Phone
- (631) 473-1320
- Fax
- (917) 328-9682
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 011582 | NY | Primary |
Addresses
Primary practice location
75 N Country Rd
Port Jefferson, NY 11777-2119
Mailing address
625 Belle Terre Rd
Suite 100
Port Jefferson, NY 11777-2316
Phone (631) 473-1320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445472000000",
"number": "1659419679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 BELLE TERRE RD",
"address_2": "SUITE 100",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772316",
"telephone_number": "631-473-1320",
"fax_number": "917-328-9682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 N COUNTRY RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772119",
"telephone_number": "631-473-1320",
"fax_number": "917-328-9682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSHI",
"first_name": "RADHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2015-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "011582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.