Active NPI
Edward O Festus, M.D,RPA
- Medical Physician Assistant
- Jackson Heights, NY
National Provider Identifier
1942389754
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective May 20, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 004555-1
- Practice address
- 8209 Roosevelt Ave FL 2
Jackson Heights, NY 11372-7034 - Phone
- (718) 507-8000
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 004555-1 | NY | Primary |
Addresses
Primary practice location
8209 Roosevelt Ave FL 2
Jackson Heights, NY 11372-7034
Mailing address
PO Box 995
Williamsbridge STN
Bronx, NY 10467-0726
Phone (914) 672-6858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004555-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942389754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 995",
"address_2": "WILLIAMSBRIDGE STN",
"city": "BRONX",
"state": "NY",
"postal_code": "104670726",
"telephone_number": "914-672-6858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8209 ROOSEVELT AVE FL 2",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727034",
"telephone_number": "718-507-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FESTUS",
"first_name": "EDWARD",
"middle_name": "O",
"credential": "M.D,RPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "004555-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.