Colleen Beth Coleman-Spiciati, PA
Individual provider Active NPI Physician Assistant · Smithtown, NY
NPI 1659318947 · NPPES record last updated Dec 10, 2015
Key facts
- NPI
- 1659318947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 008173 (NY)
- Practice address
- 519 W Jericho Tpke
Smithtown, NY 11787-2619 - Phone
- (631) 360-5900
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- State University of New York at Stony Brook, School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- CS Medical Associates, PC
Practice addresses (Care Compare)
100 Granny Rd
Suite 1
Farmingville, NY 11738-2879
Phone (631) 696-4357
2 Coraci Blvd
Suite 16
Shirley, NY 11967-4833
Phone (631) 696-4357
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060829000280 | NY | Practitioner - Physician Assistant | 5496759722 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008173 | NY | MD | General Care Registered Respiratory Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CS Medical Associates, P.C. | Current |
Accepting new patients | |
| Long Island Community Hospital at NYU Langone Health | Current |
Accepting new patients | |
| Brookhaven Memorial Hospital Medical Center, Inc. | Current |
Accepting new patients | |
| Emergency Medicine Physicians of Suffolk County, PLLC | Past | Accepting new patients |
Locations
100 Granny Rd
Ste 1
Farmingville, NY 11738
Phone (631) 666-1234
100 Granny Rd
Farmingville, NY 11738
Phone (631) 698-7828
1377 Motor Pkwy
Ste 102
Islandia, NY 11749
101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100
2 Coraci Blvd
Ste 16
Shirley, NY 11967
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 008173 | NY | Yes |
Addresses
Primary practice location
519 W Jericho Tpke
Smithtown, NY 11787-2619
Mailing address
591 W Jericho Turnpike
Smithtown, NY 11787
Phone (631) 360-5900
Other providers in Smithtown, NY
- Steven Cohen
- Cohn Plastic Surgery, PC
- Jason Eric Cohn
- Jessica M Cohn
- Colleen Danielle Cole
- Kevin Gordon Coleman
- Shayna Coleman
- Janet Ann Coletto
- Collin Em Brathwaite MD PLLC
- Lajanee Alicia Colwin
All providers in Smithtown, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.