Individual provider Active NPI

Danielle D'Alleva-Byrne, PA

  • Physician Assistant
  • Holbrook, NY
National Provider Identifier
1801966015
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009506 Issued in NY
Practice address
270 Union Ave
Holbrook, NY 11741-1823
Phone
(631) 588-7973
Fax
(631) 471-3039
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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 009506 NY Primary

Addresses

Primary practice location

270 Union Ave
Holbrook, NY 11741-1823

Mailing address

270 Union Ave
Holbrook, NY 11741-1823
Phone (631) 588-7973

Other identifiers 1

IdentifierTypeStateIssuer
03296013MedicaidNY

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
I20160512001491 NY Practitioner - Physician Assistant 5890084990 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009506NYMDPsychologist

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Mar 13, 2019 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1801966015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 UNION AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411823",
            "telephone_number": "631-588-7973",
            "fax_number": "631-471-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 UNION AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411823",
            "telephone_number": "631-588-7973",
            "fax_number": "631-471-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ALLEVA-BYRNE",
        "first_name": "DANIELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03296013",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

Verify at the official NPI Registry.