Individual provider Active NPI

Stefanie A Fadel, P.A.

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1952496481
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011043-1 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9158
Fax
(718) 226-6964
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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 011043-1 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

PO Box 409041
Atlanta, GA 30384-9041
Phone (800) 377-8721

Other identifiers 1

IdentifierTypeStateIssuer
03564569MedicaidNY

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
I20070202000468 NY Practitioner - Physician Assistant 2264434323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

10840 Queens Blvd
Forest Hills, NY 11375-5361
Phone (347) 571-5149

125 Greaves LN
Staten Island, NY 10308-2175
Phone (718) 502-8763

13434 Springfield Blvd
Springfield Gardens, NY 11413-1459
Phone (516) 537-9063

1445 Richmond Ave
Staten Island, NY 10314-1563
Phone (929) 219-0622

1555 1St Ave
New York, NY 10028-3903
Phone (212) 897-1991

1700 Hylan Blvd
Staten Island, NY 10305-1930
Phone (516) 537-9062

2590 Hylan Blvd
Unit a
Staten Island, NY 10306-4368
Phone (718) 502-9879

30 Hamilton St
Dobbs Ferry, NY 10522-2862
Phone (914) 202-2944

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

41 E 8TH St
New York, NY 10003-6450
Phone (212) 897-1991

4316 Amboy Rd
Staten Island, NY 10312-3820
Phone (929) 282-4146

5505 Myrtle Ave
Ridgewood, NY 11385-3550
Phone (718) 502-9063

5828 99TH St
Corona, NY 11368-4306
Phone (718) 502-9867

5828 99TH St Corona
Corona, NY 11368-4306
Phone (718) 502-9867

9881 Queens Blvd
Rego Park, NY 11374-4404
Phone (718) 502-9798

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011043NYMDOccupational Therapy Assistant
011043-1NYMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: stefanie.fadel@ghuc.eclinicaldirectplus.com
  • Direct secure messaging: sfadel70121@northwell.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1952496481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409041",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303849041",
            "telephone_number": "800-377-8721",
            "fax_number": "304-523-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9158",
            "fax_number": "718-226-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEL",
        "first_name": "STEFANIE",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011043-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03564569",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.