Theresa A Provetto, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002407 Issued in NY

Practice address

180 E Pulaski Rd
Huntington Station, NY 11746-1915

Phone

(631) 425-2145

Fax

(631) 425-2296

NPI assigned

Apr 17, 2006

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 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

91.79

Promoting interoperability

100

Improvement activities

40

Cost

75.18

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group NPD
• Joseph M Capo MD PC

  • Otolaryngology Physician
  • Levittown, NY
  • NPI 1063488658
  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• Island Hearing & Balance Center LLC

  • Otolaryngology Physician
  • Levittown, NY
  • NPI 1174599765
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1528022381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2145",
            "fax_number": "631-425-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2145",
            "fax_number": "631-425-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVETTO",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02066017",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tprovetto487294@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "180 E Pulaski Rd",
            "city": "Huntington Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117461915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carline Preval, MD
• Pro Health DME Solutions Inc.
• Tressa Probst, TVI
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy, P.C.
• Reynaldo Manubay Punsal, MD
• Layla Quadir, M.D.
• Bonifacio Alhambra Quilo-an Jr., PT
• Ricardo Quintanilla, PA-C
• Waqaas Ahmad Quraishi, MD

• Physician Assistant in Huntington Station, NY
• Providers in Huntington Station, 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 Mar 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.