Individual provider Active NPI

Heather M Ribaudo, RPA-C

  • Medical Physician Assistant
  • Lindenhurst, NY
National Provider Identifier
1023326634
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
014183 Issued in NY
Practice address
290 Sunrise Hwy
Lindenhurst, NY 11757-2520
Phone
(631) 226-3600
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014183 NY Primary

Addresses

Primary practice location

290 Sunrise Hwy
Lindenhurst, NY 11757-2520

Mailing address

290 Sunrise Hwy
Lindenhurst, NY 11757-2520
Phone (631) 226-3600

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
I20160623002524 NY Practitioner - Physician Assistant 3072804970 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014183NYMDHand Physical Therapist

Interoperability endpoints

  • Direct secure messaging: heather.ribaudo.1@3609.direct.athenahealth.com

Organizations & group practices 1

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": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1023326634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 SUNRISE HWY",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572520",
            "telephone_number": "631-226-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 SUNRISE HWY",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572520",
            "telephone_number": "631-226-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBAUDO",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.