Individual provider Active NPI

Colleen Beth Coleman-Spiciati, PA

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1659318947
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008173 Issued in NY
Practice address
519 W Jericho Tpke
Smithtown, NY 11787-2619
Phone
(631) 360-5900
NPI assigned
Jun 2, 2006
Last updated
Dec 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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 008173 NY Primary

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

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
I20060829000280 NY Practitioner - Physician Assistant 5496759722 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
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, PCGroup PAC ID 9335401454, 63 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008173NYMDGeneral Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince Jul 23, 2009 Accepting new patients
CS Medical Associates, P.C. CurrentSince Mar 11, 2020 Accepting new patients
Long Island Community Hospital at NYU Langone Health CurrentSince Jul 23, 2009 Accepting new patients
Emergency Medicine Physicians of Suffolk County, PLLC Past Accepting new patients

Locations

100 Granny Rd
Farmingville, NY 11738
Phone (631) 698-7828

100 Granny Rd
Ste 1
Farmingville, NY 11738
Phone (631) 666-1234

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

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1659318947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 W JERICHO TURNPIKE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-360-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 W JERICHO TPKE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872619",
            "telephone_number": "631-360-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN-SPICIATI",
        "first_name": "COLLEEN",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.