Individual provider Active NPI

Collin Patrick Duffy, PA-C

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1619699493
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029074 Issued in NY
Practice address
994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone
(631) 543-1440
NPI assigned
Sep 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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 029074 NY Primary

Addresses

Primary practice location

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211

Mailing address

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CollinDuffy_37293@timothygrothmdpc.omnimddirect.com

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
I20230227002914 NY Practitioner - Physician Assistant 1759754419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy D. Groth MD PCGroup PAC ID 8921002320, 43 clinicians

Practice addresses (Care Compare)

1500 Middle Country Rd
Centereach, NY 11720-3500
Phone (631) 543-1440

1500 William Floyd Pkwy
FL 2 Room 201
Shirley, NY 11967-1800
Phone (631) 543-1440

285 Sills Rd
East Patchogue, NY 11772-4869
Phone (631) 543-1440

994 W Jericho Tpke
Suite 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

Merit-based Incentive Payment System (MIPS)

Final score
86.89 of 100Reported as group
Quality
87.77
Promoting interoperability
100
Improvement activities
40
Cost
68.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029074NYMDPhysical Therapist

Networks

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

Interoperability endpoints

  • Direct secure messaging: collinduffy_37293@timothygrothmdpc.omnimddirect.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1619699493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873211",
            "telephone_number": "631-543-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873211",
            "telephone_number": "631-543-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "COLLIN",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CollinDuffy_37293@timothygrothmdpc.omnimddirect.com",
            "affiliation": "N",
            "address_1": "994 W Jericho Tpke Ste 104",
            "city": "Smithtown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117873211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.