Active NPI
Erica Tine-Rose Feola, P.A.
- Physician Assistant
- Watertown, NY
National Provider Identifier
1104809409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 009893-1
- Practice address
- 830 Washington St
ER Department
Watertown, NY 13601-4034 - Phone
- (315) 786-4813
- Fax
- (315) 786-4314
- NPI assigned
- Nov 22, 2005
- Last updated
- Oct 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 009893-1 | NY | Primary |
Addresses
Primary practice location
830 Washington St
ER Department
Watertown, NY 13601-4034
Mailing address
PO Box 415695
Boston, MA 02241-5695
Phone (866) 952-6774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, OH, IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009893-1 | NY | MD | Clinical Psychologist |
| 7452 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellnow Urgent Care, P.C. | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Watertown, NY
- NPI 1598713745
-
dba Hometown Urgent Care
- Urgent Care Clinic/Center
- Huber Heights, OH
- NPI 1790030385
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1205814118
-
dba WellNow Urgent Care
- Urgent Care Clinic/Center
- Watertown, NY
- NPI 1366005399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1104809409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415695",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415695",
"telephone_number": "866-952-6774",
"fax_number": "781-276-6403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 WASHINGTON ST",
"address_2": "ER DEPARTMENT",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014034",
"telephone_number": "315-786-4813",
"fax_number": "315-786-4314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEOLA",
"first_name": "ERICA",
"middle_name": "TINE-ROSE",
"name_prefix": "Ms.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-22",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "009893-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.