Individual provider Active NPI

Daniella Holzer, PA-C

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1902492226
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026324 Issued in NY
Practice address
496 Smithtown Byp Ste 200
Smithtown, NY 11787-5011
Phone
(631) 361-5300
NPI assigned
Dec 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 026324 NY Primary

Addresses

Primary practice location

496 Smithtown Byp Ste 200
Smithtown, NY 11787-5011

Mailing address

15910 71St Ave Apt 4D
Flushing, NY 11365-3028
Phone (201) 906-4434

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
I20211117000065 NY Practitioner - Physician Assistant 8022407808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albert Einstein College of Medicine of Yeshiva University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refuah Health Center IncGroup PAC ID 4880584416, 88 clinicians

Practice addresses (Care Compare)

36 Laurel Ave
South Fallsburg, NY 12779-5804
Phone (845) 482-9394

5 Twin Ave
Spring Valley, NY 10977-3950
Phone (845) 354-9300

728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Refuah Health Center, Inc. Past Accepting new patients
MK Spine and Joint Rehab, P.C. PastSince Feb 6, 2022 Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23033/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1902492226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15910 71ST AVE APT 4D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113653028",
            "telephone_number": "201-906-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP STE 200",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875011",
            "telephone_number": "631-361-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZER",
        "first_name": "DANIELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.