Individual provider Active NPI

Luther O Appiah, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1821610106
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025592 Issued in NY
Practice address
129 Waldron Ave
Staten Island, NY 10301-3618
Phone
(917) 515-4185
NPI assigned
May 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 025592 NY Primary

Addresses

Primary practice location

129 Waldron Ave
Staten Island, NY 10301-3618

Mailing address

129 Waldron Ave
Staten Island, NY 10301-3618
Phone (917) 515-4185

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
I20210419001893 NY Practitioner - Physician Assistant 6608284310 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

1210 Webster Ave
Bronx, NY 10456-4208
Phone (646) 612-7747

1332 Peninsula Blvd
Hewlett, NY 11557-1226
Phone (516) 531-6130

13337 41St Ave
Flushing, NY 11355-3630
Phone (347) 996-6840

1445 Richmond Ave
Staten Island, NY 10314-1563
Phone (929) 219-0622

1585 Dutch Broadway
Valley Stream, NY 11580-1333
Phone (516) 490-6300

1700 Hylan Blvd
Staten Island, NY 10305-1930
Phone (516) 537-9062

2128 Rockaway Pkwy
Brooklyn, NY 11236-5802
Phone (718) 489-8820

21304 Northern Blvd
Bayside, NY 11361-3344
Phone (929) 744-1197

23315 Hillside Ave
Queens Village, NY 11427-2634
Phone (718) 210-1945

2590 Hylan Blvd
Unit a
Staten Island, NY 10306-4368
Phone (718) 502-9879

332 E 149TH St
Bronx, NY 10451-5627
Phone (347) 329-4010

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

3400 Boston Rd
Bronx, NY 10469-2502
Phone (718) 290-8787

3631 Hempstead Tpke
63A
Levittown, NY 11756-1315
Phone (516) 537-9063

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

50 E Jericho Tpke
Mineola, NY 11501-3141
Phone (516) 399-3068

595 Hempstead Tpke
Suite a
West Hempstead, NY 11552-1030
Phone (347) 493-2952

683 Sunrise Hwy
Lynbrook, NY 11563-3246
Phone (516) 441-2155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025592NYMDPharmacist

Practice roles (6 of 10)

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jan 21, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Single Specialty CurrentSince May 28, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Single Specialty CurrentSince May 28, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Single Specialty Past Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients
Rockland Medical Group, PLLC Single Specialty PastSince Apr 15, 2017 Accepting new patients

Locations

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: luther.appiah@ghuc.eclinicaldirectplus.com

Organizations & group practices 11

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": "1589068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1821610106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 WALDRON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013618",
            "telephone_number": "917-515-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 WALDRON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013618",
            "telephone_number": "917-515-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPIAH",
        "first_name": "LUTHER",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.