Individual provider Active NPI

Michael Chiarenza, RPAC

  • Surgical Physician Assistant
  • West Babylon, NY
National Provider Identifier
1295085884
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
015960 Issued in NY
Practice address
60 Fleets Point Dr
West Babylon, NY 11704-8312
Phone
(631) 321-0033
Fax
(631) 321-0039
NPI assigned
Sep 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 015960 NY Primary

Addresses

Primary practice location

60 Fleets Point Dr
West Babylon, NY 11704-8312

Mailing address

60 Fleets Point Dr
West Babylon, NY 11704-8312
Phone (631) 321-0033

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
I20140603000471 NY Practitioner - Physician Assistant 3274756689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10825 Jamaica Ave
Richmond Hill, NY 11418-2243
Phone (718) 849-2321

125 Franklin Ave
Valley Stream, NY 11580-2165
Phone (516) 887-1787

485 N Ocean Ave
Patchogue, NY 11772-1762
Phone (631) 475-0353

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015960NYMDCognitive & Behavioral Psychologist

Networks

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

Organizations & group practices 1

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 3

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1295085884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FLEETS POINT DR",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048312",
            "telephone_number": "631-321-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FLEETS POINT DR",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048312",
            "telephone_number": "631-321-0033",
            "fax_number": "631-321-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIARENZA",
        "first_name": "MICHAEL",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "015960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

Verify at the official NPI Registry.