Individual provider Active NPI

Erika Spadaro

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1972264042
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001
Phone
(718) 262-2000
NPI assigned
Dec 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 PA61619677 WA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001

Mailing address

9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001

Other practice location 1

505 NE 87th Ave Ste 301
Vancouver, WA 98664-1965
Phone (360) 514-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20241213003185 WA Practitioner - Physician Assistant 2961938964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
City University of New York School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

505 NE 87TH Ave
Vancouver, WA 98664-1965

8821 NE 5TH St
Vancouver, WA 98664-3200
Phone (360) 514-1900

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
  • Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61619677WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Dec 11, 2024 Accepting new patients

Locations

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

Interoperability endpoints

  • Direct secure messaging: jfn9002@direct.nyp.org
  • Direct secure messaging: espadaro677880@direct.peacehealth.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1972264042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 GUY R BREWER BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114510001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 GUY R BREWER BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114510001",
            "telephone_number": "718-262-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 NE 87th Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641965",
            "country_code": "US",
            "telephone_number": "360-514-7060",
            "fax_number": "360-514-7068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPADARO",
        "first_name": "ERIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-31",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61619677",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.