Individual provider Active NPI

Rachel Verderosa, PA-C

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1659845899
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
023099 Issued in NY
Practice address
1825 Eastchester Rd
Bronx, NY 10461-2301
Phone
(718) 904-2000
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 023099 NY Primary

Addresses

Primary practice location

1825 Eastchester Rd
Bronx, NY 10461-2301

Mailing address

259 1St St
Mineola, NY 11501-3957
Phone (516) 663-3871

Other practice location 1

259 1st St
Mineola, NY 11501-3957
Phone (516) 663-3871

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rverderosa496447@nyumc.direct-ci.com

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
I20220629000389 NY Practitioner - Physician Assistant 7618357229 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023099NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 6, 2022 Accepting new patients
New York University CurrentSince Jul 6, 2022 Accepting new patients

Locations

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: rverderosa496447@nyumc.direct-ci.com

Organizations & group practices 2

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1659845899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612301",
            "telephone_number": "718-904-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "259 1st St",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115013957",
            "country_code": "US",
            "telephone_number": "516-663-3871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDEROSA",
        "first_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "023099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rverderosa496447@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.