Individual ProviderEvelyn BossPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address475 Seaview Ave, Staten Island, NY 10305-3436(718) 226-9158PECOS EnrollmentBased on the most recent information from CMS, provider Evelyn Boss is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1396055208Provider TypeIndividualFull NameBoss, EvelynCredentialP.A.GenderFemaleSole ProprietorNoEnumeration Date10/13/2010Last Updated7/22/2013Contact InformationPractice LocationPractice Address475 Seaview Ave, Staten Island, NY 10305-3436Phone(718) 226-9158Fax(718) 226-6964Mailing LocationMailing Address475 Seaview Ave, Staten Island, NY 10305-3436Phone(718) 226-9158Fax(718) 226-6964Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense014326New YorkProvider IdentifiersIDDescriptionIssuerID03447849DescriptionMedicaidIssuerUnlistedNew York