Individual provider Active NPI

Anthony Kwame Asiedu, P.A

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1841537008
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015916 Issued in NY
Practice address
1561 Metropolitan Ave
Apt
Bronx, NY 10462-6231
Phone
(718) 920-4581
Fax
(718) 920-4458
NPI assigned
Jan 8, 2013
Last updated
Mar 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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 015916 NY Primary

Addresses

Primary practice location

1561 Metropolitan Ave
Apt
Bronx, NY 10462-6231

Mailing address

1561 Metropolitan Ave
Apt
Bronx, NY 10462-6231
Phone (718) 920-5731

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
I20180717002162 NY Practitioner - Physician Assistant 9032466479 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015916NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 30, 2018 Accepting new patients
Montefiore Medical Center CurrentSince May 30, 2018 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Networks

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1841537008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 METROPOLITAN AVE",
            "address_2": "APT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104626231",
            "telephone_number": "718-920-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 METROPOLITAN AVE",
            "address_2": "APT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104626231",
            "telephone_number": "718-920-4581",
            "fax_number": "718-920-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASIEDU",
        "first_name": "ANTHONY",
        "middle_name": "KWAME",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-08",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.