Individual provider Active NPI

Louise Rose Cardellina, PA-C

  • Physician Assistant
  • Riverhead, NY
National Provider Identifier
1396808465
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006286 Issued in NY
Practice address
1228 E Main St
Riverhead, NY 11901-2675
Phone
(631) 603-3400
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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 006286 NY Primary

Addresses

Primary practice location

1228 E Main St
Riverhead, NY 11901-2675

Mailing address

PO Box 1027
Mattituck, NY 11952-0918
Phone (631) 298-1832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150612000254 MA Practitioner - Physician Assistant 2365681814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
73.71 of 100Reported as group
Quality
56.09
Improvement activities
40
Cost
79.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DRX UC Worcester PC CurrentSince Jul 31, 2018 Accepting new patients
Afc Physicians of Massachusetts, PC CurrentSince Apr 19, 2015 Accepting new patients

Locations

117 Stafford St
Ste A
Worcester, MA 01603
Phone (508) 755-4010

Organizations & group practices 4

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1396808465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119520918",
            "telephone_number": "631-298-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012675",
            "telephone_number": "631-603-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDELLINA",
        "first_name": "LOUISE",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.