Individual provider Active NPI

Michael Demarest, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1841248747
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005865 Issued in NY
Practice address
100 E 77TH St
New York, NY 10021-1850
Phone
(212) 434-2650
Fax
(212) 434-4512
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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 005865 NY Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10021-1850

Mailing address

100 E 77TH St
New York, NY 10021-1850
Phone (212) 434-2650

Other identifiers 1

IdentifierTypeStateIssuer
01868506MedicaidNY

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
I20090305000447 NY Practitioner - Physician Assistant 8426114083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

125 Greaves LN
Staten Island, NY 10308-2175
Phone (718) 502-8763

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

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

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

2935 Veterans Rd W
Suite B
Staten Island, NY 10309-2514
Phone (347) 705-7121

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

4316 Amboy Rd
Staten Island, NY 10312-3820
Phone (929) 282-4146

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Lenox Emergency Medicine, PC Past Accepting new patients
LH Emergency Medical Services PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.demarest@ghuc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1841248747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211850",
            "telephone_number": "212-434-2650",
            "fax_number": "212-434-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211850",
            "telephone_number": "212-434-2650",
            "fax_number": "212-434-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAREST",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01868506",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.