Individual provider Active NPI

Rita A Yeretsian, M.D.

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1710184437
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
244285 Issued in NY
Practice address
NYU School of Medicine
550 1St Ave
New York, NY 10016
Phone
(212) 686-7500
NPI assigned
Jun 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 244285 NY Primary

Addresses

Primary practice location

NYU School of Medicine
550 1St Ave
New York, NY 10016

Mailing address

564 1St Ave
Apt 16C
New York, NY 10016-6482
Phone (917) 301-2491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090724000469 NJ Practitioner - Diagnostic Radiology 4486707312 Reassigns benefits to 1 organization
I20220620000092 NY Practitioner - Diagnostic Radiology 4486707312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Pittsburgh School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jun 11, 2009 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Mar 9, 2022 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Summit Medical Group PA CurrentSince Jun 11, 2009 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Mar 9, 2022 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

Networks

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

Interoperability endpoints

  • Direct secure messaging: rita.yeretsian.1@2983.direct.athenahealth.com

Organizations & group practices 5

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710184437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 1ST AVE",
            "address_2": "APT 16C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166482",
            "telephone_number": "917-301-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NYU SCHOOL OF MEDICINE",
            "address_2": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-686-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERETSIAN",
        "first_name": "RITA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "244285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.