Individual provider Active NPI

Antaeya Nyree Foster, PA-C

  • Surgical Physician Assistant
  • Pomona, NY
National Provider Identifier
1760769152
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
014459 Issued in NY
Practice address
31 Halley Dr
Pomona, NY 10970-2001
Phone
(845) 664-0740
Fax
(845) 354-7735
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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 014459 NY Primary

Addresses

Primary practice location

31 Halley Dr
Pomona, NY 10970-2001

Mailing address

170 Williams Street
7TH Floor
New York, NY 10038
Phone (212) 312-5400

Other names 1

  • Antaeya Nyree Leake-Gaylord Former name

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
I20120111000449 NY Practitioner - Physician Assistant 0547437766 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dobbs Ferry Emergency Medicine, PCGroup PAC ID 8022908268, 39 clinicians

Practice addresses (Care Compare)

128 Ashford Ave
Dobbs Ferry, NY 10522-1924
Phone (914) 964-4370

967 N Broadway
Yonkers, NY 10701-1301
Phone (914) 964-4370

Hospital & facility affiliations

  • St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014459NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 29, 2019 Accepting new patients
Symphony Medical PC CurrentSince Nov 15, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jun 29, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23390/brand/1/csg/1/fhir/r4
  • Direct secure messaging: anl9157@direct.nyp.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1760769152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 WILLIAMS STREET",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10038",
            "telephone_number": "212-312-5400",
            "fax_number": "845-354-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HALLEY DR",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702001",
            "telephone_number": "845-664-0740",
            "fax_number": "845-354-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "ANTAEYA",
        "middle_name": "NYREE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "014459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTAEYA",
            "last_name": "LEAKE-GAYLORD",
            "middle_name": "NYREE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pomona, NY

Sources for this page

Verify at the official NPI Registry.