Individual provider Active NPI

Lisa Trentino, PA

  • Physician Assistant
  • West Islip, NY
National Provider Identifier
1003385352
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022979 Issued in NY
Practice address
400 Montauk Hwy Ste 102
West Islip, NY 11795-4429
Phone
(631) 533-2723
Fax
(631) 257-0850
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022979 NY Primary

Addresses

Primary practice location

400 Montauk Hwy Ste 102
West Islip, NY 11795-4429

Mailing address

400 Montauk Hwy Ste 102
West Islip, NY 11795-4429
Phone (631) 533-2723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230327001105 NY Practitioner - Physician Assistant 1456725837 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reginald M Rousseau MD PC CurrentSince Jan 1, 2026 Accepting new patients

Locations

100 Motor Pkwy
Ste LL8
Hauppauge, NY 11788

1175 Montauk Hwy
Ste 6
West Islip, NY 11795
Phone (631) 422-5371

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8502/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1003385352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY STE 102",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "631-533-2723",
            "fax_number": "631-257-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY STE 102",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "631-533-2723",
            "fax_number": "631-257-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENTINO",
        "first_name": "LISA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.