Individual provider Active NPI

Janessa Pietrucha

  • Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1528475654
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017649 Issued in NY
Practice address
7901 Broadway
Elmhurst, NY 11373-1329
Phone
(718) 334-4000
NPI assigned
Jul 21, 2014
Last updated
Jul 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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 017649 NY Primary

Addresses

Primary practice location

7901 Broadway
Elmhurst, NY 11373-1329

Mailing address

806 5TH Ave
Brooklyn, NY 11232-1801
Phone (347) 834-2449

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
I20170731002020 NY Practitioner - Physician Assistant 8729359401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
New York College of Osteo Medicine of New York Institute of Technology, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

138 Delancey St
New York, NY 10002-3325
Phone (212) 609-2541

216 E 14TH St
New York, NY 10003-4105

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

87 Chambers St
New York, NY 10007-1805
Phone (212) 335-0594

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jul 1, 2017 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jul 1, 2017 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: janessa.pietrucha.1@2983.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1528475654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112321801",
            "telephone_number": "347-834-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRUCHA",
        "first_name": "JANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.