Active NPI
Theresa Ann Raposo Marques, MPAS; APA
- Surgical Physician Assistant
- Middletown, NY
National Provider Identifier
1508823212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 021883
- Practice address
- 707 E Main St
Middletown, NY 10940-2650 - Phone
- (845) 333-7575
- Fax
- (845) 333-7202
- NPI assigned
- Apr 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | 021883 | NY | Primary |
Addresses
Primary practice location
707 E Main St
Middletown, NY 10940-2650
Mailing address
707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575
Other practice location 1
68 Harris Bushville Rd
Harris, NY 12742-2650
Phone (845) 794-0996
Other practice location 2
707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575
Other practice location 3
102 Clowes Ave
Goshen, NY 10924-1956
Phone (845) 333-7200
Other practice location 4
38 Concord Rd
Monticello, NY 12701-3210
Phone (845) 333-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05479543 | Medicaid | NY |
Other names 1
- Theresa Ann Hanes
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | traposomarques52184@direct.garnethealth.org | Garnet Health Doctors PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021883 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1508823212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-7575",
"fax_number": "845-333-7202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-7575",
"fax_number": "845-333-7202"
}
],
"practiceLocations": [
{
"address_1": "68 Harris Bushville Rd",
"address_purpose": "LOCATION",
"city": "Harris",
"state": "NY",
"postal_code": "127422650",
"country_code": "US",
"telephone_number": "845-794-0996",
"fax_number": "845-796-1404",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "707 E Main St",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "NY",
"postal_code": "109402650",
"country_code": "US",
"telephone_number": "845-333-7575",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "102 Clowes Ave",
"address_purpose": "LOCATION",
"city": "Goshen",
"state": "NY",
"postal_code": "109241956",
"country_code": "US",
"telephone_number": "845-333-7200",
"fax_number": "845-333-7208",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "38 Concord Rd",
"address_purpose": "LOCATION",
"city": "Monticello",
"state": "NY",
"postal_code": "127013210",
"country_code": "US",
"telephone_number": "845-333-6500",
"fax_number": "845-333-6501",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAPOSO MARQUES",
"first_name": "THERESA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MPAS; APA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-27",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "021883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05479543",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "traposomarques52184@direct.garnethealth.org",
"affiliation": "Y",
"affiliationName": "Garnet Health Doctors PC",
"address_1": "707 E Main St",
"city": "Middletown",
"state": "NY",
"country_code": "US",
"postal_code": "109402650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "THERESA",
"last_name": "HANES",
"middle_name": "ANN",
"credential": "MPAS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.