Individual provider Active NPI

Rebecca Danielle Triana, RPA-C,MSPAS

  • Physician Assistant
  • Commack, NY
National Provider Identifier
1386668309
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007350 Issued in NY
Practice address
5036 Jericho Tpke Ste 203
Commack, NY 11725-2812
Phone
(917) 746-5436
Fax
(702) 485-6746
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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 007350 NY Primary

Addresses

Primary practice location

5036 Jericho Tpke Ste 203
Commack, NY 11725-2812

Mailing address

PO Box 252
Northport, NY 11768-0252
Phone (917) 746-5436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210815000056 NY Practitioner - Physician Assistant 5799189668 Reassigns benefits to 2 organizations
I20240724002290 MI Practitioner - Physician Assistant 5799189668 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince May 1, 2024 Accepting new patients
New York Neuromodulation Medical PLLC Past Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: rebeccatriana@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: rtriana321870@northwell.direct-ci.com

Organizations & group practices 5

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1386668309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117680252",
            "telephone_number": "917-746-5436",
            "fax_number": "702-485-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE STE 203",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "917-746-5436",
            "fax_number": "702-485-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIANA",
        "first_name": "REBECCA",
        "middle_name": "DANIELLE",
        "credential": "RPA-C,MSPAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.