Individual provider Active NPI

Calli Alexandra Carnavas

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1881215309
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025344 Issued in NY
Practice address
355 Bard Ave
Staten Island, NY 10310-1664
Phone
(718) 818-2995
NPI assigned
May 6, 2020
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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 025344 NY Primary

Addresses

Primary practice location

355 Bard Ave
Staten Island, NY 10310-1664

Mailing address

355 Bard Ave
Staten Island, NY 10310-1664
Phone (718) 818-2995

Other practice location 1

506 6th St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

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
I20201012000908 NY Practitioner - Physician Assistant 7214357326 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025344NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 1, 2023 Accepting new patients
New York University CurrentSince Feb 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2022 Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2022 Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Interoperability endpoints

  • Direct secure messaging: ccarnavas539797@nyumc.direct-ci.com

Organizations & group practices 9

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1881215309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARNAVAS",
        "first_name": "CALLI",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2022-05-19",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.