Ryan Dekenipp, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

363A00000X Issued in NY

Practice address

340 Howells Rd Ste 2B
Bay Shore, NY 11706-5322

Phone

(833) 547-7463

Fax

(631) 318-9830

NPI assigned

Jan 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amit Sharma MD PCGroup PAC ID 0244666915, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

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.

• Amit Sharma MD PC

  • Interventional Pain Medicine Physician
  • Bay Shore, NY
  • NPI 1669014197
  Medicare reassignment Care Compare group
• North Shore Long Island Jewish Healthcare

  • Cardiovascular Disease Physician
  • Westbury, NY
  • NPI 1215019500
  Medicare reassignment NPD
• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  Medicare reassignment
• North Shore Long Island Jewish Health Care Inc

  • Internal Medicine Physician
  • New York, NY
  • NPI 1912338385
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1306550140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOTOR PKWY STE LL8",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885165",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HOWELLS RD STE 2B",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065322",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "182 Main St",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117436987",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4250 Hempstead Tpke Ste 4",
            "address_purpose": "LOCATION",
            "city": "Bethpage",
            "state": "NY",
            "postal_code": "117145707",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Commack Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117253405",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKENIPP",
        "first_name": "RYAN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "363A00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell R Decasteele, LPN
• Lisa Defeis, LCSW
• Christy K Defournoy
• Anthony Degelorm, PHARMD
• Stephanie J Dejoseph
• Edward Delano, M.D.
• Myrna Delarosamatos, RN
• Michael Robert Delman, MD
• Danielle Lee Deluca, R.D., C.D.N.
• Giuseppe Amedeo Demeo, H.I.S.

• Physician Assistant in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.