Active NPI
Fabian J Rentas
- Medical Physician Assistant
- Elmhurst, NY
National Provider Identifier
1851727572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 016975
- Practice address
- 9131 Queens Blvd
Elmhurst, NY 11373-5555 - Phone
- (718) 454-2222
- NPI assigned
- Sep 26, 2013
- Last updated
- Oct 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 016975 | NY | Primary |
Addresses
Primary practice location
9131 Queens Blvd
Elmhurst, NY 11373-5555
Mailing address
9131 Queens Blvd
Elmhurst, NY 11373-5555
Phone (718) 454-2222
Other names 1
- Fabian J Rentas
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016975 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PMGT Medical and Surgical Associates LLP | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- far9055@direct.nyp.org
- frentas19049@sbhny.direct-ci.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475366400000",
"number": "1851727572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9131 QUEENS BLVD",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113735555",
"telephone_number": "718-454-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9131 QUEENS BLVD",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113735555",
"telephone_number": "718-454-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENTAS",
"first_name": "FABIAN",
"middle_name": "J",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-26",
"last_updated": "2016-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "016975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "FABIAN",
"last_name": "RENTAS",
"middle_name": "J",
"credential": "PA-C",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.