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

Individual provider Physician Assistant · NPI 1467263491

Carin Liela Gannon is a Physician Assistant in New York, New York. Qualified in 2025, 1 year ago. Practices with Icahn School of Medicine at Mount Sinai, a 2,791-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New York.

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

1 Gustave L Levy Pl # 1149
New York, NY 10029-6504
Phone: (203) 913-9582
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 25-10 30th Ave, Astoria, NY 11102-2418 — (203) 913-9582
  • 1225 Morris Park Ave, Bronx, NY 10461-1949 — (646) 592-4753

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 033317 (NY)

Record details

NPI number1467263491
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 17, 2025
Last updated in NPPESJune 12, 2025
Certification dateJune 12, 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)
Group practice Icahn School Of Medicine At Mount Sinai — 2791 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Icahn School of Medicine at Mount Sinai

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 2791 clinicians in the practice; 12 are shown here.

Other providers in New York