Individual provider Active NPI

Kate Ryan Cecchetto, RPA-C

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1184923112
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014654 Issued in NY
Practice address
290 E Main St Ste 700
Smithtown, NY 11787
Phone
(631) 361-5302
Fax
(631) 361-5376
NPI assigned
Mar 16, 2011
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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 014654 NY Primary

Addresses

Primary practice location

290 E Main St Ste 700
Smithtown, NY 11787

Mailing address

290 E Main St Ste 700
Smithtown, NY 11787-2916
Phone (631) 361-4802

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)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
E.S. Mango, M.D., P.C. CurrentSince May 22, 2018 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
HSS Non Par Providers Past Accepting new patients

Locations

290 E Main St
Ste 700
Smithtown, NY 11787
Phone (631) 361-4802

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Interoperability endpoints

  • Direct secure messaging: kate.cecchetto@direct.stonybrookmedicine.edu

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, 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": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1184923112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 E MAIN ST STE 700",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872916",
            "telephone_number": "631-361-4802",
            "fax_number": "631-361-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 E MAIN ST STE 700",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-361-5302",
            "fax_number": "631-361-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECCHETTO",
        "first_name": "KATE",
        "middle_name": "RYAN",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.