Individual provider Active NPI

Caroline Grace Garretson

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1134946130
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone
(631) 543-1440
NPI assigned
Sep 23, 2024
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 NY Primary

Addresses

Primary practice location

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211

Mailing address

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CarolineGarretson_38666@timothygrothmdpc.omnimddirect.com Health Information Exchange (HIE)

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
I20250402001631 NY Practitioner - Physician Assistant 6103349972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy D. Groth MD PCGroup PAC ID 8921002320, 43 clinicians

Practice addresses (Care Compare)

1500 William Floyd Pkwy
FL 2 Room 201
Shirley, NY 11967-1800
Phone (631) 543-1440

994 W Jericho Tpke
Suite 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

National Provider Directory

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

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1134946130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873211",
            "telephone_number": "631-543-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873211",
            "telephone_number": "631-543-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETSON",
        "first_name": "CAROLINE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CarolineGarretson_38666@timothygrothmdpc.omnimddirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "994 W Jericho Tpke Ste 104",
            "city": "Smithtown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117873211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.