Kevin Whitley, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005562 Issued in NY

Practice address

100 Port Washington Blvd
Roslyn, NY 11576-1353

Phone

(516) 338-5300

NPI assigned

Feb 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841325453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1048",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501048",
            "telephone_number": "516-338-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-338-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "KEVIN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Alysanne Weiss, DDS
• Jason Wells, M.D.
• Craig Weschke, RPA-C
• Kelly Whalen, AGACNP-C
• Steven White
• Dahlia-Dean D Whorms, NP
• James Gilbert Widyn, M.D.
• Dewi Wijaya
• Stephen A Wiley, DPT
• Jason Wilner

• Physician Assistant in Roslyn, NY
• Providers in Roslyn, 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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.