Individual provider Active NPI

Nicole Josephine Tuffarelli, PA-C

  • Medical Physician Assistant
  • Garden City, NY
National Provider Identifier
1104988542
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
07754-1 Issued in NY
Practice address
54 New Hyde Park Road
Garden City, NY 11530
Phone
(516) 488-1313
Fax
(516) 488-1368
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 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 07754-1 NY Primary

Addresses

Primary practice location

54 New Hyde Park Road
Garden City, NY 11530

Mailing address

54 New Hyde Park Road
Garden City, NY 11530
Phone (516) 488-1313

Other names 1

  • Ms. Nicole Josephine Cassara Former name

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
I20080407000517 NY Practitioner - Physician Assistant 1153408745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph Onorato MD PCGroup PAC ID 6800801655, 14 clinicians

Practice addresses (Care Compare)

54 New Hyde Park Rd
Garden City, NY 11530-3909
Phone (516) 488-1313

Merit-based Incentive Payment System (MIPS)

Final score
93.82 of 100Reported as group
Quality
87.63
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07754-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Onorato M.D., P.C. CurrentSince May 14, 2018 Accepting new patients
Garden City Dermatology, PC Past Accepting new patients

Locations

54 New Hyde Park Rd
Garden City, NY 11530
Phone (516) 488-1313

100 Village Sq
Ste 170
Glen Cove, NY 11542
Phone (516) 676-3554

Networks

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

Organizations & group practices 3

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1104988542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 NEW HYDE PARK ROAD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-488-1313",
            "fax_number": "516-488-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 NEW HYDE PARK ROAD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-488-1313",
            "fax_number": "516-488-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUFFARELLI",
        "first_name": "NICOLE",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "07754-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "CASSARA",
            "middle_name": "JOSEPHINE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.