NPIMap

Individual provider Active NPI

Elissa Nicole Solomon, PA-C

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1679122725
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5024 Issued in CT
Practice address
535 E 70TH St
New York, NY 10021-4823
Phone
(212) 606-1065
Fax
(212) 774-7317
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1168557 NY
Physician Assistant 363A00000X NY
Surgical Physician Assistant 363AS0400X 024193 NY
Surgical Physician Assistant 363AS0400X 5024 CT Primary

Addresses

Primary practice location

535 E 70TH St
New York, NY 10021-4823

Mailing address

535 E 70TH St
New York, NY 10021-4823
Phone (212) 606-1065

Other practice location 1

6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145

Other practice location 2

1 Blachley Rd
Stamford, CT 06902-0002
Phone (203) 705-2113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201123002554 NY Practitioner - Physician Assistant 1658782636 Reassigns benefits to 1 organization
I20201130000139 CT Practitioner - Physician Assistant 1658782636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alexander McLawhorn MD PLLCGroup PAC ID 2961739719, 2 clinicians

Practice addresses (Care Compare)

32 Strawberry Hill CT
Stamford, CT 06902-2594
Phone (203) 705-2113

535 E 70TH St
New York, NY 10021-4823
Phone (212) 606-1065

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1168557NYMDPhysician Assistant
5024CTMDSurgical Physician Assistant

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.

Hospital & facility affiliations 11

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1679122725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-606-1065",
            "fax_number": "212-774-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-606-1065",
            "fax_number": "212-774-7317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Greenwich Office Park",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068315151",
            "country_code": "US",
            "telephone_number": "203-869-1145",
            "fax_number": "203-618-1721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Blachley Rd",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069020002",
            "country_code": "US",
            "telephone_number": "203-705-2113",
            "fax_number": "203-705-2925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "ELISSA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1168557",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "024193",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "5024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.