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

Ashley Bubolo

Individual provider Physician Assistant · NPI 1730978214

Ashley Bubolo is a Physician Assistant in New York, New York. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025

Practice location Address checks out

419 W 114th St
New York, NY 10025-1710
Phone: (212) 523-4000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 034237 (NY)

Record details

NPI number1730978214
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 2, 2025
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025

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)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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