Individual provider Active NPI

Veronica Ann Marciano, MS, RPAC

  • Surgical Physician Assistant
  • Manhasset, NY
National Provider Identifier
1558678912
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
014129 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 983-6428
NPI assigned
Sep 8, 2010
Last updated
Sep 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014129 NY
Surgical Physician Assistant 363AS0400X 014129 NY Primary

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

17 Boston Ave
Medford, NY 11763-3204
Phone (516) 983-6428

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
I20120830000119 NY Practitioner - Physician Assistant 4284881079 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
014129-1NYMDOccupational Therapist
014129NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital CurrentSince Nov 1, 2020 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Nov 1, 2020 Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients

Locations

100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

Organizations & group practices 7

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": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1558678912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BOSTON AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633204",
            "telephone_number": "516-983-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-983-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCIANO",
        "first_name": "VERONICA",
        "middle_name": "ANN",
        "credential": "MS, RPAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014129",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "014129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.