Individual provider Active NPI

Amanda Rainey, PA-C

  • Physician Assistant
  • Bay Shore, NY
National Provider Identifier
1144935933
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029575 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(631) 968-3000
NPI assigned
Jan 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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 029575 NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

9 Basswood LN
Smithtown, NY 11787-4502
Phone (631) 672-0673

Other practice location 1

270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2000

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
I20230405001427 NY Practitioner - Physician Assistant 6608241633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peconic Bay Primary Medical CareGroup PAC ID 7113817602, 72 clinicians

Practice addresses (Care Compare)

34 Commerce Ave
Riverhead, NY 11901-3118
Phone (631) 727-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029575NYMDPhysician Assistant

Networks

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

Interoperability endpoints

  • Direct secure messaging: arainey69684@northwell.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1144935933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BASSWOOD LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874502",
            "telephone_number": "631-672-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117432787",
            "country_code": "US",
            "telephone_number": "631-351-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.