Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andy Nan

Individual provider Physician Assistant · NPI 1104708254

Andy Nan is a Physician Assistant in Elmhurst, New York. Qualified in 2025, 1 year ago. Practices with Hicksville Family Medical Care PLLC, a 45-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
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Practice location Address checks out

9425 60th Ave
Elmhurst, NY 11373-5069
Phone: (718) 760-0797
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104708254
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 21, 2025
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025
Mailing address209 Evergreen Ave, Bethpage, NY 11714-1221

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Hicksville Family Medical Care Pllc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Elmhurst