Individual provider Active NPI

Janet Dellatacoma, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1306382478
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020528 Issued in NY
Practice address
1414 Victory Blvd
Staten Island, NY 10301-3908
Phone
(718) 447-1261
Fax
(718) 981-1856
NPI assigned
Jan 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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 020528 NY Primary

Addresses

Primary practice location

1414 Victory Blvd
Staten Island, NY 10301-3908

Mailing address

1414 Victory Blvd
Staten Island, NY 10301-3908
Phone (718) 447-1261

Other names 1

  • Janet Ye Former name

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
I20170418002508 NY Practitioner - Physician Assistant 6103102629 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2187 Richmond Ave
Staten Island, NY 10314-3920
Phone (646) 682-7364

2710 Hylan Blvd
Staten Island, NY 10306-4658
Phone (718) 489-3551

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

5788 -5800 Amboy Rd
Staten Island, NY 10309-3137
Phone (718) 571-9716

812 Forest Ave
Staten Island, NY 10310-2446
Phone (718) 571-9196

8712 4TH Ave
Brooklyn, NY 11209-5110
Phone (718) 530-1155

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

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Oct 21, 2024 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Oct 21, 2024 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 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

Interoperability endpoints

  • Direct secure messaging: janet.dellatacoma.1@2983.direct.athenahealth.com

Organizations & group practices 7

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": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1306382478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013908",
            "telephone_number": "718-447-1261",
            "fax_number": "718-981-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013908",
            "telephone_number": "718-447-1261",
            "fax_number": "718-981-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLATACOMA",
        "first_name": "JANET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "YE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.