Azalesha Abrahim Rodriguez, M.S. PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00232600 Issued in NY

Practice address

1855 Richmond Ave
Staten Island, NY 10314-3940

Phone

(718) 697-2212

NPI assigned

May 13, 2010

Last updated

Mar 27, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Azalesha Abrahim Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1760700843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143940",
            "telephone_number": "718-697-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143940",
            "telephone_number": "718-697-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AZALESHA",
        "middle_name": "ABRAHIM",
        "name_prefix": "Mrs.",
        "credential": "M.S. PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "25MP00232600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AZALESHA",
            "last_name": "ABRAHIM",
            "credential": "M.S. PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rodolfo Ocampo Rodolfo
• Andrea M Rodolico
• Kim Rodriguez-Loggins, FNP
• Alexandra Yasel Rodriguez
• Alina Lauren Rodriguez
• Barbara M Rodriguez, MSW
• Candee Melgar Rodriguez, NP
• Daniel Rodriguez Jr., MT
• Deborah Ann Rodriguez
• Destiny Rodriguez

• Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.