Individual provider Active NPI

Fiona Eapen, RPA-C

  • Physician Assistant
  • Bellmore, NY
National Provider Identifier
1710112289
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010511 Issued in NY
Practice address
2592 Merrick Rd Unit B
Bellmore, NY 11710-5742
Phone
(516) 826-7800
NPI assigned
May 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY
Physician Assistant 363A00000X 010511 NY Primary

Addresses

Primary practice location

2592 Merrick Rd Unit B
Bellmore, NY 11710-5742

Mailing address

444 Merrick Rd
Ste LL2
Lynbrook, NY 11563-2400
Phone (516) 599-4242

Other practice location 1

21008 Northern Blvd
Suite 2
Bayside, NY 11361-3211
Phone (718) 224-8200

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
I20100729000128 NY Practitioner - Physician Assistant 3476686387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Dermatologic Associates, LLPGroup PAC ID 8022900869, 10 clinicians

Practice addresses (Care Compare)

444 Merrick Rd
Suite LL2
Lynbrook, NY 11563-2400
Phone (516) 599-4242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010511NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Dermatologic Associates, LLP PastSince Feb 14, 2021 Accepting new patients

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": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1710112289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MERRICK RD",
            "address_2": "STE LL2",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632400",
            "telephone_number": "516-599-4242",
            "fax_number": "516-599-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 MERRICK RD UNIT B",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105742",
            "telephone_number": "516-826-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21008 Northern Blvd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113613211",
            "country_code": "US",
            "telephone_number": "718-224-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EAPEN",
        "first_name": "FIONA",
        "name_prefix": "Miss",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

Verify at the official NPI Registry.