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ALICIA ANDERSON
NPI 1104584622
Physician Assistant in Ronkonkoma, NY

Active since December 01, 2021PECOS Enrolled
650 HAWKINS AVE STE 7, RONKONKOMA, NY 11779(631) 737-0055(631) 737-0076 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2022, Dec 1, 2021 (2 updates tracked since 2021).

About Alicia Anderson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALICIA ANDERSON (NPI 1104584622) is an individual physician assistant in Ronkonkoma, New York and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104584622
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameALICIA ANDERSON
Location Address650 HAWKINS AVE STE 7Ronkonkoma, NY 11779-2366
Mailing Address650 Hawkins Ave Ste 7Ronkonkoma, NY 11779-2366 · (631) 737-0055 · Fax (631) 737-0076
Phone(631) 737-0055
Fax(631) 737-0076
Sole ProprietorYes
Enumeration DateDecember 1, 2021
Last NPPES UpdateFebruary 11, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2022
✔ NPI 1104584622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
650 HAWKINS AVE STE 7, Ronkonkoma, NY 11779
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alicia Anderson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11779 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JILLIAN K CHAN MD
Psychiatry & Neurology (Neurology)
650 HAWKINS AVE STE 7
RONKONKOMA, NY 11779
Suffolk County (631) 737-0055
MS. CARINNE NICOLE CARDONA FNP
Nurse Practitioner (Family)
650 HAWKINS AVE STE 7
RONKONKOMA, NY 11779
Suffolk County (631) 737-0055
EUN AH HELMS PA-C
Psychiatry & Neurology (Neurology)
650 HAWKINS AVE STE 7
RONKONKOMA, NY 11779
Suffolk County (631) 737-0055
AMANDA MARIE MEYERRICKS PA-C
Physician Assistant
650 HAWKINS AVE STE 7
RONKONKOMA, NY 11779
Suffolk County (631) 737-0055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alicia Anderson's NPI number?

The NPI number for Alicia Anderson is 1104584622. It was assigned to this individual provider in the NPPES registry on December 1, 2021.

Where is Alicia Anderson located?

Alicia Anderson practices at 650 Hawkins Ave Ste 7, Ronkonkoma, NY 11779. The listed phone number is (631) 737-0055.

What is Alicia Anderson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Alicia Anderson enrolled in Medicare?

Yes. Alicia Anderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alicia Anderson was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.