Travis Etwaroo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

020713 Issued in NY

Practice address

890 Hunts Point Ave
Bronx, NY 10474-5402

Phone

(718) 589-2440

NPI assigned

Mar 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: travis.etwaroo.1@15450.direct.athenahealth.com

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.

• Urban Health Plan, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1265596548
  Medicare reassignment NPD
• Urban Health Plan, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1386247542
  NPD

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1699215012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 HUNTS POINT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104745402",
            "telephone_number": "718-589-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 HUNTS POINT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104745402",
            "telephone_number": "718-589-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETWAROO",
        "first_name": "TRAVIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronit Etra, DMD
• Norman Arthur Ettenger, MD
• Hugh Marshall Ettlinger, D.O.
• Ebere Etufugh-Nwankpa
• Eno Roseline Etukudo
• Simone E Eudovic, P. T.
• Alexa Nicole Eugene
• Euromedical Urgent Care
• Tanairi Eusebio Cruz
• Lilia A Evangelista, M.D.

• Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.

Verify at the official NPI Registry.