Individual provider Active NPI

Angela V Pantelias, RPA-C

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1851592927
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0037321 Issued in NY
Practice address
15211 89TH Ave
2ND Floor Orthopaedics
Jamaica, NY 11432-3730
Phone
(718) 558-7240
Fax
(718) 558-6181
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 0037321 NY Primary

Addresses

Primary practice location

15211 89TH Ave
2ND Floor Orthopaedics
Jamaica, NY 11432-3730

Mailing address

202 Friedenstein Rd
Long Eddy, NY 12760-5906
Phone (845) 887-2060

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
I20170613000010 NY Order and Referring Only - Physician Assistant 1052689270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0037321NYMDPhysician Assistant

Networks

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

Interoperability endpoints

  • Direct secure messaging: apantelias838994@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1851592927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FRIEDENSTEIN RD",
            "city": "LONG EDDY",
            "state": "NY",
            "postal_code": "127605906",
            "telephone_number": "845-887-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15211 89TH AVE",
            "address_2": "2ND FLOOR ORTHOPAEDICS",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323730",
            "telephone_number": "718-558-7240",
            "fax_number": "718-558-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTELIAS",
        "first_name": "ANGELA",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0037321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.