Individual provider Active NPI

Elana Coscetta, PA

  • Advanced Practice Midwife
  • Kings Park, NY
National Provider Identifier
1881795813
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
008242-1 Issued in NY
Practice address
93 Main Street
Suite a
Kings Park, NY 11754
Phone
(631) 292-2725
Fax
(631) 292-2727
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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 008242-1 NY
Advanced Practice Midwife 367A00000X 008242-1 NY Primary

Addresses

Primary practice location

93 Main Street
Suite a
Kings Park, NY 11754

Mailing address

93 Main Street
Suite a
Kings Park, NY 11754
Phone (631) 292-2725

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
I20100420000083 NY Practitioner - Physician Assistant 7214064575 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008242-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital CurrentSince Mar 4, 2010 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Mar 4, 2010 Accepting new patients

Locations

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Organizations & group practices 3

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1881795813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 MAIN STREET",
            "address_2": "SUITE A",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-292-2725",
            "fax_number": "631-292-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 MAIN STREET",
            "address_2": "SUITE A",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-292-2725",
            "fax_number": "631-292-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSCETTA",
        "first_name": "ELANA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008242-1",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "008242-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

Verify at the official NPI Registry.