Emily Joan Cavanaugh

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

033219 Issued in NY

Practice address

21 Eastport Manor Rd
Eastport, NY 11941-1410

Phone

(631) 325-2255

NPI assigned

Feb 17, 2025

Last updated

Feb 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8524/brand/1/csg/1/fhir/r4

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.

• First Choice Medical PLLC

  • Internal Medicine Physician
  • Holbrook, NY
  • NPI 1043355159
  NPD
• R&T Medical PC

  • Family Medicine Physician
  • East Patchogue, NY
  • NPI 1093066953
  NPD

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1679378475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HIAWATHA DR",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EASTPORT MANOR RD",
            "city": "EASTPORT",
            "state": "NY",
            "postal_code": "119411410",
            "telephone_number": "631-325-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "EMILY",
        "middle_name": "JOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "033219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Alexa Addonisio, M. S. CCC-SLP
• Asha Antony, PA
• Lisa Kathleen Berg-Anderson, M.S.
• Ada Eileen Catala, PT
• Theresa Ceruti, MS
• Shannon Tracy Constantine
• Helen Denniston, P.T.
• William T Donovan, PH.D., LMHC
• Dr Richard J Dackow Psychology Services

• Medical Physician Assistant in Eastport, NY
• Providers in Eastport, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.