Individual provider Active NPI

Paula Fedorovsky

  • Medical Physician Assistant
  • Springfield Township, NJ
National Provider Identifier
1760024665
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00545700 Issued in NJ
Practice address
355 US Route 22
Springfield Township, NJ 07081
Phone
(973) 467-2767
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 25MP00545700 NJ Primary

Addresses

Primary practice location

355 US Route 22
Springfield Township, NJ 07081

Mailing address

31 Waterview CT
Staten Island, NY 10305-3147
Phone (347) 208-9966

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
I20221004003451 NY Practitioner - Physician Assistant 9133531619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

1989 Merrick Rd
Merrick, NY 11566-4643
Phone (516) 584-4448

235 Glen Cove Rd
Carle Place, NY 11514-1221
Phone (516) 877-2273

2459 Merrick Rd
Bellmore, NY 11710-5703
Phone (516) 826-2273

3276 Hempstead Tpke
Levittown, NY 11756-1345
Phone (516) 796-2273

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

415 Northern Blvd
Great Neck, NY 11021-4812
Phone (516) 829-2273

560 Merrick Rd
Rockville Centre, NY 11570-5445
Phone (516) 858-2373

585 Merrick Rd
Lynbrook, NY 11563-2311
Phone (516) 764-2273

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Sep 12, 2022 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 12, 2022 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: paula.fedorovsky.1@2983.direct.athenahealth.com

Organizations & group practices 3

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": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1760024665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WATERVIEW CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053147",
            "telephone_number": "347-208-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 US ROUTE 22",
            "city": "SPRINGFIELD TOWNSHIP",
            "state": "NJ",
            "postal_code": "07081",
            "telephone_number": "973-467-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOROVSKY",
        "first_name": "PAULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00545700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.