Individual provider Active NPI

Nathaly Y Adolphe, P.A.

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1740518489
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013702 Issued in NY
Practice address
304 Park Ave S
New York, NY 10010-4301
Phone
(212) 213-6155
Fax
(212) 213-6188
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013702 NY Primary

Addresses

Primary practice location

304 Park Ave S
New York, NY 10010-4301

Mailing address

304 Park Ave S
New York, NY 10010-4301
Phone (212) 213-6155

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
I20260212000242 NY Order and Referring Only - Physician Assistant 5294039194

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
L'Refuah Medical and Rehabilitation Center, Inc.Group PAC ID 8628068731, shared by 4 NPIs, 17 clinicians

Practice addresses (Care Compare)

3710 13TH Ave
Brooklyn, NY 11218-3602
Phone (718) 686-7600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 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": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1740518489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 PARK AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104301",
            "telephone_number": "212-213-6155",
            "fax_number": "212-213-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 PARK AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104301",
            "telephone_number": "212-213-6155",
            "fax_number": "212-213-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADOLPHE",
        "first_name": "NATHALY",
        "middle_name": "Y",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.