Active NPI
Justin Michael Fallacaro, PA-C
- Surgical Physician Assistant
- Middletown, NY
National Provider Identifier
1659920767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 024728
- Practice address
- 707 E Main St
Middletown, NY 10940-2650 - Phone
- (845) 333-7575
- Fax
- (845) 333-7201
- NPI assigned
- Sep 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 024728 | NY | Primary |
Addresses
Primary practice location
707 E Main St
Middletown, NY 10940-2650
Mailing address
707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575
Other practice location 1
68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06045005 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jfallacaro68753@direct.garnethealth.org | Direct | Garnet Health Doctors PC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8909
707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575
Hospital & facility affiliations
- Garnet Health Medical Center
- Garnet Health Medical Center Catskills
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.22 of 100
- Quality
- 82.55
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 64.86
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.1 of 100
- Quality
- 61
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.76
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
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.
-
- General Practice Physician
- Middletown, NY
- NPI 1093138851
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Middletown, NY
- NPI 1609875772
-
- Rural Acute Care Hospital
- Harris, NY
- NPI 1710977012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729036800000",
"number": "1659920767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-7575",
"fax_number": "845-333-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-7575",
"fax_number": "845-333-7201"
}
],
"practiceLocations": [
{
"address_1": "68 Harris Bushville Rd",
"address_purpose": "LOCATION",
"city": "Harris",
"state": "NY",
"postal_code": "12742",
"country_code": "US",
"telephone_number": "845-333-8909",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FALLACARO",
"first_name": "JUSTIN",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-11",
"last_updated": "2024-10-16",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "024728",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06045005",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jfallacaro68753@direct.garnethealth.org",
"affiliation": "Y",
"affiliationName": "Garnet Health Doctors PC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "707 E Main St",
"city": "Middletown",
"state": "NY",
"country_code": "US",
"postal_code": "109402650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.