Shane Thomas Martensen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

35 The Moor
East Islip, NY 11730-2922

Phone

(631) 383-2476

NPI assigned

Jan 18, 2021

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Francis HospitalGroup PAC ID 9234101221, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Merit-based Incentive Payment System (MIPS)

Final score

90.12 of 100Reported as group

Quality

88.22

Promoting interoperability

100

Improvement activities

40

Cost

73.09

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles (3 of 7)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• 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.

• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1760704811
  Medicare reassignment Care Compare group NPD
• Suffolk Cardiac Care PLLC

  • Cardiovascular Disease Physician
  • East Patchogue, NY
  • NPI 1902183627
  Medicare reassignment
• St. Francis Hospital

  • Cardiovascular Disease Physician
  • West Islip, NY
  • NPI 1528386810
  NPD
• St Francis Hospital United States Catholic Conference

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1750439030
  NPD (past)

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

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1336738913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 THE MOOR",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302922",
            "telephone_number": "631-383-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 THE MOOR",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302922",
            "telephone_number": "631-383-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENSEN",
        "first_name": "SHANE",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Maiorella, LCSW
• Matthew F Mangione, PT
• Tracy Lynn Marino, LMT
• Sarah N Marrero
• Fallon Kathleen Martensen
• Mary Ozegovich LCSW PC
• Suzanne Mason-Grossmann, MHC
• Bakul N Matalia, R.PH.
• Matthew Colucci P.T.,P.C.
• Melani Ann Maxwell

• Physician Assistant in East Islip, NY
• Providers in East Islip, 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 Jan 18, 2021; 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.