Active NPI
Cynthia Desravines, PA
- Physician Assistant
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 011470-1
- Practice address
- 1400 Pelham Pkwy S
Bronx, NY 10461-1138 - Phone
- (718) 918-3060
- Fax
- (718) 918-4469
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 011470-1 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Mailing address
21516 111TH Ave
Queens Village, NY 11429-1911
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011470-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Lawrence Medical Associates, PC | Current | Accepting new patients | |
| Lawrence Medical Associates, PC | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Mount Vernon Hospital | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
2475 Saint Raymonds Ave
Bronx, NY 10461
Phone (718) 430-7300
685 White Plains Rd
Fl 2
Eastchester, NY 10709
Phone (914) 787-4100
12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511
16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
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.
-
- Internal Medicine Physician
- Yorktown Heights, NY
- NPI 1023257441
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Emergency Medicine Physician
- New Rochelle, NY
- NPI 1649200015
-
- Emergency Medicine Physician
- Bronx, NY
- NPI 1205944329
-
- Multi-Specialty Clinic/Center
- Yorktown Heights, NY
- NPI 1184115479
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- General Acute Care Hospital
- Mount Vernon, NY
- NPI 1013345065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730229196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21516 111TH AVE",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114291911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-918-3060",
"fax_number": "718-918-4469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESRAVINES",
"first_name": "CYNTHIA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "011470-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.