Dennis Waxman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001355 Issued in NY

Practice address

111 Sullivan Ave
Ferndale, NY 12734-4315

Phone

(845) 292-6630

Fax

(845) 794-9868

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Catskill Regional Medical Center

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1902997091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "address_2": "CRMC PHYSICIAN SERVICES",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "127420421",
            "telephone_number": "845-794-9864",
            "fax_number": "845-794-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SULLIVAN AVE",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "127344315",
            "telephone_number": "845-292-6630",
            "fax_number": "845-794-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "001355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01969891",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prem Prakash Gupta M.D P.C
• David Schwalb, MD
• Michael E Schwartz, PSYD., MSCP.
• Devorah Schwebel, CCC-SLP
• Linda Rene Thompson, NP
• Yvonne C Newland Pagan MD PC

• Physician Assistant in Ferndale, NY
• Providers in Ferndale, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.