KELLY R EMMERT (NPI# 1518342088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518342088 |
| Entity Type | Individual |
| Full Name | KELLY R EMMERT |
| Other Name | KELLY RENEE LEWIS |
| Credential | PA-C |
| Practice Address |
125 Mineola Ave Suite 200 Roslyn Heights NY 11577-2023 |
| Practice Telephone | 5166165500 |
| Practice Fax Number | 8885026585 |
| Mailing Telephone | 5166165500 |
| Mailing Fax Number | 8885026585 |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2019-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
018867 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
125 MINEOLA AVE SUITE 200 |
| City | ROSLYN HEIGHTS |
| State | NY |
| Zip Code | 11577-2023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326114067 | David Michael Gardner | Dentist | 125 Mineola Ave, Suite 304, Roslyn Heights, NY 11577 | 2006-11-27 |
| 1679057715 | Emily L Rogan | Physician Assistant | 125 Mineola Ave, Roslyn Heights, NY 11577-2023 | 2018-09-24 |
| 1164898821 | Premier Bariatric Surgery, Pllc | Specialist | 125 Mineola Ave, Suite 200, Roslyn Heights, NY 11577-2023 | 2015-08-18 |
| 1023307352 | Pankti R Patel | Surgery | 125 Mineola Ave, Suite 200, Roslyn Heights, NY 11577-2023 | 2011-04-07 |
| 1043470834 | Kevin Howard Small | Plastic Surgery | 125 Mineola Ave, Ste 200, Roslyn Heights, NY 11577-2042 | 2008-06-15 |
| 1104093582 | Kathi A Kassover | Counselor | 125 Mineola Ave, 107, Roslyn Heights, NY 11577-2023 | 2008-05-14 |
| 1346413242 | Wen-ting Jeffrey Chiao | Surgery | 125 Mineola Ave, Suite 200, Roslyn Heights, NY 11577-2023 | 2008-04-11 |
| 1356545867 | Long Island Minimally Invasive Surgery, P.C. | Specialist | 125 Mineola Ave, Suite 200, Roslyn Heights, NY 11577-2023 | 2007-06-11 |
| 1073658829 | Lee A Schneider | Social Worker | 125 Mineola Ave, Roslyn Heights, NY 11577-2023 | 2007-02-20 |
| 1407999386 | Stephanie Mona Zemon | Social Worker | 125 Mineola Ave, 105, Roslyn Heights, NY 11577-2023 | 2007-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275059669 | Roslyn Family Dental, P.C. | Dentist | 86 Mineola Ave, Roslyn Heights, NY 11577 | 2017-08-17 |
| 1740719822 | Kids R Us Services | Early Intervention Provider Agency | 68 Macgregor Ave, Roslyn Heights, NY 11577 | 2017-06-12 |
| 1598202665 | Jennifer Kaylin Puciloski | Physician Assistant | 125 Mineola Avenue, Suite 200, Roslyn Heights, NY 11577 | 2017-01-26 |
| 1821547746 | Jason David Rosenfeld | Dentist | 216 Willis Ave Ste 1, Roslyn Heights, NY 11577 | 2016-10-04 |
| 1255701892 | Child Services Inc Ny | Case Management | 59 Colony Lane, Roslyn Heights, NY 11577 | 2015-09-25 |
| 1669881405 | Niaz Nassiri | Specialist | 20 Jane St., Roslyn Hts, NY 11577 | 2014-08-06 |
| 1578812525 | Lori Karson | Specialist | 42 Midland Road, Roslyn Heights, NY 11577 | 2012-09-06 |
| 1558627604 | Rona T Weiss | Psychologist | 220 South Service Road, Suite 15, Roslyn Heights, NY 11577 | 2012-04-03 |
| 1679848196 | Kuo-chung Chang | Acupuncturist | 59 Mineola Ave, Roslyn Heights, NY 11577 | 2012-03-16 |
| 1285904359 | Barbara R Silverman | Speech-Language Pathologist | 475 Round Hll Rd, Roslyn Heights, NY 11577 | 2012-01-06 |
| Find all providers in zip 11577 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174165484 | Sarah Desiree Kennedy-etheridge | Physician Assistant | 125 Mineola Ave Ste 200, Roslyn Heights, NY 11577-2042 | 2019-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434727 | Julia Loren Bartsch | Physician Assistant | 11791 Genesee St, Alden, NY 14004-9713 | 2020-10-16 |
| 1295347078 | Alana Janine Miller | Physician Assistant | 1060 5th Ave # 1b, New York, NY 10128-0104 | 2020-08-21 |
| 1336768647 | Abul Sarker | Physician Assistant | 2 Sagamore Ave, Suffern, NY 10901-7412 | 2020-04-16 |
| 1689200412 | Margaret Ann Sullivan | Physician Assistant | 7011 108th St Apt 4l, Forest Hills, NY 11375-4407 | 2020-03-12 |
| 1376177527 | Anabell Marina Lopez Plaza | Physician Assistant | 12 Berrywood Ct, Bay Shore, NY 11706-2058 | 2020-02-26 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1831736602 | Ll Physician Assistant PC | Physician Assistant | 2279 Coney Island Ave Fl 2, Brooklyn, NY 11223-3337 | 2019-11-29 |
| 1992348775 | Nafiur Rahman Chowdhury | Physician Assistant | 8268 164th St Rm A3-65, Jamaica, NY 11432-1121 | 2019-10-23 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1578114377 | Matthew Newmark Eisenstein | Physician Assistant | 3260 43rd St Apt 2r, Astoria, NY 11103-2745 | 2019-09-23 |
| Find all providers with the same taxonomy | ||||
| City | ROSLYN HEIGHTS |
| Zip Code | 11577 |
Please comment or provide details below to improve the information on KELLY R EMMERT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.