Individual provider Active NPI

Eric Seth Jiang, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1891524500
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032044 Issued in NY
Practice address
813 Southern Blvd
Bronx, NY 10459-5202
Phone
(516) 833-5505
NPI assigned
Jul 31, 2024
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 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 032044 NY Primary

Addresses

Primary practice location

813 Southern Blvd
Bronx, NY 10459-5202

Mailing address

4218 147TH St Apt 3G
Flushing, NY 11355-1392
Phone (718) 666-5736

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
I20251210002257 NY Practitioner - Physician Assistant 2163916859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 325-7520

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Services, P.C. CurrentSince Sep 20, 2025 Accepting new patients

Locations

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1891524500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 147TH ST APT 3G",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551392",
            "telephone_number": "718-666-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104595202",
            "telephone_number": "516-833-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "ERIC",
        "middle_name": "SETH",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.