Linda Wynne, RPAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006266-1 Issued in NY

Practice address

815 Hallock Ave
Port Jefferson Station, NY 11776-1220

Phone

(631) 331-7267

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: linda.wynne@direct.stonybrookmedicine.edu

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.

• Stony Brook Children'S Service, University Faculty Practice Corporatio

  • Pediatrics Physician
  • Stony Brook, NY
  • NPI 1083660575
  Medicare reassignment
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1043231699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SILAS WOODS RD",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761220",
            "telephone_number": "631-331-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "LINDA",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006266-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Howard Winston, MD
• Andrew Witrock, D.M.D.
• Jennifer Wong, RPH
• Rosalie L. Wong, M.D.
• Woodhaven Adult Home, LLC
• Sinem Yilmaz
• Andrea Yorek
• Paul Young I
• Diana Youngs, ANPC
• Nianhwa Yu, MSED

• Medical Physician Assistant in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.