Individual provider Active NPI

Jose Renter, P.A.

  • Physician Assistant
  • Farmingdale, NY
National Provider Identifier
1265568547
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005426 Issued in NY
Practice address
1111 Route 110
Farmingdale, NY 11735-4820
Phone
(631) 752-7000
NPI assigned
Feb 23, 2007
Last updated
Oct 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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 005426 NY Primary

Addresses

Primary practice location

1111 Route 110
Farmingdale, NY 11735-4820

Mailing address

74 Cornell LN
Hicksville, NY 11801-3310
Phone (516) 822-0641

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
I20071112000656 NY Practitioner - Physician Assistant 1254426166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1117 Old Country Rd
Plainview, NY 11803-5019
Phone (516) 938-5900

1757 Sunrise Hwy
Bay Shore, NY 11706-6014

234 W Jericho Tpke
Huntington Station, NY 11746-3628
Phone (631) 423-5400

292 Herricks Rd
Mineola, NY 11501-1119
Phone (516) 746-2273

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

358 Jericho Tpke
Syosset, NY 11791-4544
Phone (516) 677-9200

4410 Sunrise Hwy
Massapequa, NY 11758-5346
Phone (516) 998-1024

656 Wellwood Ave
N
Lindenhurst, NY 11757-1695
Phone (631) 225-4227

901 Sunrise Hwy
Copiague, NY 11726-1300
Phone (631) 841-5900

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005426NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Sep 5, 2018 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 5, 2018 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1265568547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 CORNELL LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013310",
            "telephone_number": "516-822-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ROUTE 110",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354820",
            "telephone_number": "631-752-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTER",
        "first_name": "JOSE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

Verify at the official NPI Registry.