Individual provider Active NPI

Ileana Eileen Alicea, PA

  • Surgical Physician Assistant
  • Bronx, NY
National Provider Identifier
1750577508
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
012069 Issued in NY
Practice address
234 E 149TH St
Bronx, NY 10451-5504
Phone
(718) 579-5000
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 012069 NY Primary

Addresses

Primary practice location

234 E 149TH St
Bronx, NY 10451-5504

Mailing address

234 E 149TH St
Bronx, NY 10451-5504
Phone (718) 579-5900

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
I20120309000599 NY Practitioner - Physician Assistant 0648439604 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012069NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Nov 1, 2022 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Nov 1, 2022 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: ialicea839451@nychhc.direct-ci.com

Organizations & group practices 6

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1750577508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5900",
            "fax_number": "718-334-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA",
        "first_name": "ILEANA",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "012069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.