Individual provider Active NPI

Caitlyn Scheuerman, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1851630693
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017880-1 Issued in NY
Practice address
401 Bloomingdale Rd Ste W
Staten Island, NY 10309-2010
Phone
(718) 317-0941
Fax
(718) 317-0942
NPI assigned
Feb 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00295800 NJ
Physician Assistant 363A00000X 017880-1 NY Primary

Addresses

Primary practice location

401 Bloomingdale Rd Ste W
Staten Island, NY 10309-2010

Mailing address

401 Bloomingdale Rd Ste 2
Staten Island, NY 10309-2070
Phone (718) 317-0941

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
I20170317000344 NY Practitioner - Physician Assistant 4981989779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

65 Stockton Ave
Princeton, NJ 08540-8523

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017880-1NYMDSpeech-Language Pathologist
25MP00295800NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Javier Zelaya, MD PC PastSince Mar 1, 2021 Accepting new patients

Organizations & group practices 2

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": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1851630693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BLOOMINGDALE RD STE 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092070",
            "telephone_number": "718-317-0941",
            "fax_number": "718-317-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BLOOMINGDALE RD STE W",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092010",
            "telephone_number": "718-317-0941",
            "fax_number": "718-317-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEUERMAN",
        "first_name": "CAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00295800",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017880-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.