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MR. ELLIOT S FORMAL PA-C
NPI 1649834656
Physician Assistant - Medical in Astoria, NY

Active since April 24, 2019PECOS Enrolled
2510 30TH AVE, ASTORIA, NY 11102(718) 932-1000 Get Directions Write a Review

NPPES record last updated: April 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2023, Apr 24, 2019 (2 updates tracked since 2019).

About Mr. Elliot S Formal Pa-c NPPES

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

MR. ELLIOT S FORMAL PA-C (NPI 1649834656) is an individual medical provider in Astoria, New York, licensed in New York (024373) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649834656
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. ELLIOT S FORMALCredential: PA-C
Location Address2510 30TH AVEAstoria, NY 11102-2418
Mailing Address3450 28th St Apt 2hAstoria, NY 11106-3533 · (609) 502-3182
Phone(718) 932-1000
Sole ProprietorNo
Enumeration DateApril 24, 2019
Last NPPES UpdateApril 10, 20232 updates tracked since enumeration
NPPES CertifiedApril 10, 2023
✔ NPI 1649834656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 024373
2510 30TH AVE, Astoria, NY 11102
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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)

Mr. Elliot S Formal Pa-c 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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
22 services22 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
12 services12 patients

Other Providers at the Same Location NPPES 20

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

ASIF MURSHED CHOWDHURY PA-C
Physician Assistant
2510 30TH AVE
LONG ISLAND CITY, NY 11102
Queens County (718) 932-1000
KAMILIA AIT BELKACEM PA
Physician Assistant
2510 30TH AVE
ASTORIA, NY 11102
Queens County (347) 862-8380
NIA GRANT PA
Physician Assistant
2510 30TH AVE
LONG ISLAND CITY, NY 11102
Queens County (718) 932-1000
JEAN CLAUDE BAYLE MD
Surgery
2510 30TH AVE
LONG ISLAND CITY, NY 11102
Queens County (718) 267-4245
JENNIFER WANG
Physician Assistant
2510 30TH AVE
ASTORIA, NY 11102
Queens County (718) 267-4262
MR. MIYASEKI SAKAEDA PARAGAS NP
Nurse Practitioner (Family)
2510 30TH AVE
LONG ISLAND CITY, NY 11102
Queens County (718) 808-7790
DR. MARIAM NOOR
Pharmacist
2510 30TH AVE
LONG ISLAND CITY, NY 11102
Queens County (718) 932-1000
KAREN XU RPH
Pharmacist
2510 30TH AVE
ASTORIA, NY 11102
Queens County (718) 267-4267

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 Elliot Formal's NPI number?

The NPI number for Elliot Formal is 1649834656. It was assigned to this individual provider in the NPPES registry on April 24, 2019.

Where is Elliot Formal located?

Elliot Formal practices at 2510 30th Ave, Astoria, NY 11102. The listed phone number is (718) 932-1000.

What is Elliot Formal's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Elliot Formal enrolled in Medicare?

Yes. Elliot Formal is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elliot Formal was last updated on April 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.