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

Judith Casanova, PA

Individual provider Physician Assistant · NPI 1467617688

Judith Casanova, PA is a Physician Assistant in Brooklyn, New York. Qualified in 2008, 18 years ago. Practices with Outer Banks Professional Services, LLC, a 162-clinician group and accepts Medicare assignment. Licensed in Florida and New York.

Years since qualifying
18
Licensed in
FL, NY
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1456 Fulton St
Brooklyn, NY 11216-2607
Phone: (718) 636-4500
Fax: (347) 296-8365
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9105079 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 012567 (NY)

Record details

NPI number1467617688
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 28, 2008
Last updated in NPPESJanuary 28, 2021
Certification dateJanuary 28, 2021
Mailing address1456 Fulton St, Brooklyn, NY 11216-2607

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Outer Banks Professional Services, Llc — 162 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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