Nidda Komal, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1 Healthy Way
Oceanside, NY 11572-1551

Phone

(347) 419-1053

NPI assigned

Jul 3, 2024

Last updated

Jul 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mount Sinai School of Medicine

  dba Mount Sinai Marathon Medical

  • Internal Medicine Physician
  • Oceanside, NY
  • NPI 1508127531
  Medicare reassignment
• Mount Sinai School of Medicine

  • Hematology & Oncology Physician
  • Rockville Centre, NY
  • NPI 1013484039
  NPD
• Mount Sinai School of Medicine

  • Psychiatry Physician
  • Hempstead, NY
  • NPI 1508333956
  NPD

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1811733496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 6TH ST",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015430",
            "telephone_number": "347-419-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "347-419-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAL",
        "first_name": "NIDDA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Klein, DPM
• Jeena Kokura, P.A.
• Marian V Kolarsky, MD
• Roshan Kollipara
• Diana Koltsova, PT, DPT
• Dmitry Konsky, D.O.
• Foula Chrissy Kontonicolas, MD
• Diana Catherine Kontonotas-Willis, DO
• Akua T Kordieh
• Brett Kornblum

• Physician Assistant in Oceanside, NY
• Providers in Oceanside, 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 Jul 3, 2024; 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.