Samantha Jenna Debello

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

11 Schuyler Dr
Jericho, NY 11753-1911

Phone

(516) 510-2218

NPI assigned

Oct 15, 2019

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

Specialty

Physician Assistant

Education

State University of New York Downstate Medical Center, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

85.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sde4005@direct.nyp.org

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.

• Weill Medical College of Cornell

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1013958610
  Medicare reassignment Care Compare group NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Cornell University Medical College

  • Psychologist
  • White Plains, NY
  • NPI 1528084910
  NPD (past)
• Weill Medical College of Cornell

  • Gynecologic Oncology Physician
  • New York, NY
  • NPI 1952345647
  NPD (past)

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1144862723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SCHUYLER DR",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531911",
            "telephone_number": "516-510-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SCHUYLER DR",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531911",
            "telephone_number": "516-510-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBELLO",
        "first_name": "SAMANTHA",
        "middle_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nestor Luis Cora, LMT
• Cosmoplastic Surgery PLLC
• CVS Albany LLC
• Paulina Czerkas
• DBM Medical PLLC
• Julia Marie Deedy X, LMSW
• Colleen Dejoseph, LMFT
• Howard M Delman
• Vivian Delman, RD
• Lois Ann Depasquale, MS, CCC/SLP

• Physician Assistant in Jericho, NY
• Providers in Jericho, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.