Individual provider Active NPI

Micaela Rose Fontanetta

  • Physician Assistant
  • Yonkers, NY
National Provider Identifier
1174317127
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2290 Central Park Ave
Yonkers, NY 10710-1216
Phone
(914) 337-5437
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 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 Primary

Addresses

Primary practice location

2290 Central Park Ave
Yonkers, NY 10710-1216

Mailing address

2290 Central Park Ave
Yonkers, NY 10710-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics of Bayside PLLC Past Accepting new patients
PM Pediatrics PC Past Accepting new patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics of Bayside, PLLC Past Accepting new patients
Night Lite Pediatric Center, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1174317127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 CENTRAL PARK AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107101216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 CENTRAL PARK AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107101216",
            "telephone_number": "914-337-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANETTA",
        "first_name": "MICAELA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.