Individual provider Active NPI

Heather Kurdali, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1942517271
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00238900 Issued in NJ
Practice address
331 6TH Ave
New York, NY 10014-4403
Phone
(212) 219-2659
Fax
(212) 867-5309
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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 25MP00238900 NJ Primary

Addresses

Primary practice location

331 6TH Ave
New York, NY 10014-4403

Mailing address

1345 RXR PLZ FL 13
Uniondale, NY 11556-1301
Phone (516) 453-0435

Other practice location 1

901 W Main St
Freehold, NJ 07728-2537
Phone (732) 431-2000

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
I20180306002293 NY Practitioner - Physician Assistant 4789871153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00238900NJMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1942517271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 RXR PLZ FL 13",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115561301",
            "telephone_number": "516-453-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144403",
            "telephone_number": "212-219-2659",
            "fax_number": "212-867-5309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 W Main St",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077282537",
            "country_code": "US",
            "telephone_number": "732-431-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURDALI",
        "first_name": "HEATHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00238900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.