Individual provider Active NPI

Kelly Elizabeth Lifavi, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1861938698
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
461 Fulton St FL 2
Brooklyn, NY 11201-5207
Phone
(718) 571-9418
NPI assigned
Jan 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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 Primary

Addresses

Primary practice location

461 Fulton St FL 2
Brooklyn, NY 11201-5207

Mailing address

1345 Avenue of the Americas FL 8
New York, NY 10105-0018
Phone (212) 913-0828

Other practice location 1

8900 Van Wyck Expy
Richmond Hill, NY 11418-2832
Phone (718) 206-6058

Other names 1

  • Kelly Elizabeth Bocchino Former name

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
I20170331000183 NY Practitioner - Physician Assistant 3678858875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

129 Sunrise Hwy W
Patchogue, NY 11772-1846
Phone (631) 230-5775

1757 Sunrise Hwy
Bay Shore, NY 11706-6014

1850 Sunrise Hwy
Bay Shore, NY 11706-6012
Phone (631) 581-5900

1930 Deer Park Ave
Deer Park, NY 11729-3328
Phone (631) 254-5900

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

5600 Sunrise Hwy
Sayville, NY 11782-1017
Phone (631) 563-7828

600 Portion Rd
Ronkonkoma, NY 11779-1867
Phone (631) 471-5900

656 Wellwood Ave
N
Lindenhurst, NY 11757-1695
Phone (631) 225-4227

996 Middle Country Rd
Selden, NY 11784-2511
Phone (631) 736-5900

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020592NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Jamaica Hospital CurrentSince Mar 27, 2017 Accepting new patients
Jamaica Hospital CurrentSince Mar 27, 2017 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

461 Fulton St
Fl 2
Brooklyn, NY 11201
Phone (718) 571-9418

1345 Avenue of the Americas
Fl 8
New York, NY 10105
Phone (212) 913-0828

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

Interoperability endpoints

  • Direct secure messaging: kelly.lifavi.1@2983.direct.athenahealth.com

Organizations & group practices 5

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": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1861938698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050018",
            "telephone_number": "212-913-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 FULTON ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015207",
            "telephone_number": "718-571-9418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-6058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIFAVI",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-18",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BOCCHINO",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.