Individual provider Active NPI

Erica Avvento McBride, PA-C

  • Physician Assistant
  • Roslun, NY
National Provider Identifier
1487904165
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015828 Issued in NY
Practice address
St. Francis Hospital
100 Port Washington Blvd
Roslun, NY 11576
Phone
(516) 562-3000
NPI assigned
Sep 11, 2012
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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 015828 NY Primary

Addresses

Primary practice location

St. Francis Hospital
100 Port Washington Blvd
Roslun, NY 11576

Mailing address

St. Francis Hospital
100 Port Washington Blvd
Roslun, NY 11576
Phone (516) 562-3000

Other names 1

  • Erica Lynn Avvento Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130926000668 NY Practitioner - Physician Assistant 5890939151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015828NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Unbridled Aesthetics Physician Assistant Current Accepting new patients
Good Samaritan Hospital Medical CurrentSince Apr 10, 2014 Accepting new patients
Good Samaritan Hospital CurrentSince Apr 10, 2014 Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1487904165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST. FRANCIS HOSPITAL",
            "address_2": "100 PORT WASHINGTON BLVD",
            "city": "ROSLUN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-562-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. FRANCIS HOSPITAL",
            "address_2": "100 PORT WASHINGTON BLVD",
            "city": "ROSLUN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-562-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "ERICA",
        "middle_name": "AVVENTO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "AVVENTO",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Sources for this page

Verify at the official NPI Registry.