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

Mallory Nakamura, PA

Individual provider Medical Physician Assistant · NPI 1558994574

Mallory Nakamura, PA is a Physician Assistant in Bethpage, New York. Qualified in 2019, 7 years ago. Practices with Montefiore Medical Center, a 2,796-clinician group. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone: (516) 579-6000
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 024639 (NY)

Record details

NPI number1558994574
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 18, 2020
Last updated in NPPESDecember 3, 2022
Certification dateDecember 3, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Montefiore Medical Center — 2796 clinicians
Accepts Medicare assignment Not indicated

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