Individual provider Active NPI

James Edward Antes, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1831462068
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22124 Issued in CA
Practice address
301 E 17TH St Ste 230
New York, NY 10003-3804
Phone
(212) 598-6000
NPI assigned
Feb 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 021578 NY
Physician Assistant 363A00000X 22124 CA Primary

Addresses

Primary practice location

301 E 17TH St Ste 230
New York, NY 10003-3804

Mailing address

6458 84TH St
Middle Village, NY 11379-2437
Phone (323) 383-7967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180904002621 NY Practitioner - Physician Assistant 6507016060 Reassigns benefits to 3 organizations
I20240315000246 WI Practitioner - Physician Assistant 6507016060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021578NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Apr 1, 2024 Accepting new patients
New York University CurrentSince Jul 18, 2018 Accepting new patients
New York University CurrentSince Jul 18, 2018 Accepting new patients
Jamaica Hospital CurrentSince Apr 1, 2024 Accepting new patients
Flushing Hospital Medical Center CurrentSince Apr 1, 2024 Accepting new patients

Locations

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

301 E 17th St
Ste 230
New York, NY 10003
Phone (212) 598-6000

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Organizations & group practices 6

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": "1329609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1831462068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6458 84TH ST",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792437",
            "telephone_number": "323-383-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST STE 230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-598-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTES",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-19",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "021578",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.