Individual provider Active NPI

Judith Gautier-Scipione, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1770673642
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002808 Issued in NY
Practice address
1825 Eastchester Road
Montefiore Hospital
Bronx, NY 10461
Phone
(718) 904-2400
Fax
(718) 904-2827
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002808 NY Primary

Addresses

Primary practice location

1825 Eastchester Road
Montefiore Hospital
Bronx, NY 10461

Mailing address

2463 Lodovick Ave PH
Bronx, NY 10469-6247
Phone (718) 862-4228

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
I20050215000481 NY Practitioner - Physician Assistant 5597717876 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jul 23, 2015 Accepting new patients
Montefiore Medical Center CurrentSince Jul 23, 2015 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
#9
Bronx, NY 10467
Phone (718) 920-5442

1695 Eastchester Rd
Bronx, NY 10461
Phone (718) 405-8020

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

111 E 210th St
Bronx, NY 10467

Networks

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

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437177600000",
    "number": "1770673642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2463 LODOVICK AVE PH",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696247",
            "telephone_number": "718-862-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER ROAD",
            "address_2": "MONTEFIORE HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-904-2400",
            "fax_number": "718-904-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTIER-SCIPIONE",
        "first_name": "JUDITH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.