Individual ProviderMandy XiPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address475 Seaview Ave, Staten Island, NY 10305-3436(718) 226-9250PECOS EnrollmentBased on the most recent information from CMS, provider Mandy Xi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1669940896Provider TypeIndividualFull NameXi, MandyCredentialPA-CGenderFemaleSole ProprietorYesEnumeration Date11/6/2018Last Updated12/30/2019Contact InformationPractice LocationPractice Address475 Seaview Ave, Staten Island, NY 10305-3436Phone(718) 226-9250FaxUnlisted FaxMailing LocationMailing Address475 Seaview Ave, Staten Island, NY 10305-3436PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense022968New YorkProvider IdentifiersIDDescriptionIssuerID022968DescriptionOtherIssuerNYS LICENSING DEPARTMENT FOR PA-CNew YorkID1157035DescriptionOtherIssuerNCCPANew YorkID440014956DescriptionOtherIssuerNYS LEARNER PERMITNew York