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Stelin Johnson

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

256 Mason Ave, Building B, 2nd Floor, Staten Island, NY 10305-3408

PECOS Enrollment

Based on the most recent information from CMS, provider Stelin Johnson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1306928577
Provider Type
Individual
Full Name
Johnson, Stelin
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
10/19/2006
Last Updated
2/15/2016

Contact Information

Practice Location

256 Mason Ave, Building B, 2nd Floor, Staten Island, NY 10305-3408

(718) 226-1300

Unlisted Fax

Mailing Location

3400 Bainbridge Ave, 4th Floor, Dept Of Surgery, Bronx, NY 10467-2404

(718) 920-4800

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 009588 New York

Stelin Johnson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Cho, Eunice

Goldberg, Regina

Pol-Wnuk, Monika

Compton, Korrine A

Raineri, Caterina O

Yeung, Tszman

Cepeda, Roger Alejandro

Hanna, Catherine

Tantawi, Nada Sherif

Harris, Karen