Individual provider Active NPI

Alyssa Laxer, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1710609755
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029191 Issued in NY
Practice address
163 William St FL 5
New York, NY 10038-2602
Phone
(212) 618-6052
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 029191 NY Primary

Addresses

Primary practice location

163 William St FL 5
New York, NY 10038-2602

Mailing address

163 William St FL 5
New York, NY 10038-2602

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
I20230109001836 NY Practitioner - Physician Assistant 3971973959 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 6103251491, 50 clinicians

Practice addresses (Care Compare)

234 E 85TH St
New York, NY 10028-3001
Phone (646) 605-5669

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029191NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 19, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 19, 2022 Accepting new patients
Fpa Hospital Based CurrentSince Dec 19, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

300 Cadman Plz W
Fl 18
Brooklyn, NY 11201
Phone (929) 210-6000

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1468 Madison Ave
#3220
New York, NY 10029

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

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

Organizations & group practices 7

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 6

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1710609755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 WILLIAM ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 WILLIAM ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382602",
            "telephone_number": "212-618-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAXER",
        "first_name": "ALYSSA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.