Joan Venerosa, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010571 Issued in NY

Practice address

700 S. Perry St.
St. Mary'S Hospital Fam HLTH CNTR at Johnstown Pediatri
Johnstown, NY 12095

Phone

(518) 762-3161

Fax

(518) 762-6751

NPI assigned

Dec 12, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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 Marys Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1518926401
  Medicare reassignment NPD
• Carondelet Regional Medical, PC

  • General Practice Physician
  • Broadalbin, NY
  • NPI 1861939944
  Medicare reassignment
• St. Mary'S Healthcare

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Amsterdam, NY
  • NPI 1700636347
  NPD
• St. Mary'S Healthcare

  • Psychiatric Hospital Unit
  • Amsterdam, NY
  • NPI 1164497103
  NPD (past)
• Atlantic Physician Services of Maryland, PC

  • Physician Assistant
  • Baltimore, MD
  • NPI 1174632376
  NPD (past)

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1386629483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE - PRIMARY & SPECIALTY CARE DEPT.",
            "address_2": "ST. MARY'S HOSPITAL AT AMSTERDAM",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-841-7430",
            "fax_number": "518-841-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S. PERRY ST.",
            "address_2": "ST. MARY'S HOSPITAL FAM HLTH CNTR AT JOHNSTOWN PEDIATRI",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "12095",
            "telephone_number": "518-762-3161",
            "fax_number": "518-762-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEROSA",
        "first_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-12",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0010571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS U/W",
            "identifier": "491537001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "318412",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02327282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Care, Inc.
• Bernadette Lois Van Wie, R.N.
• Stacey J Vanbuskirk, PA
• Teresa Marie Varano, OTR/L
• Jennifer Vassar, CPT
• Walgreen Co
• Holly B Walrath
• Todd Walton, O.D.
• Sally A Webber, RN
• Wells Nursing Home Inc.

• Physician Assistant in Johnstown, NY
• Providers in Johnstown, 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 Sep 2, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.