Individual provider Active NPI

Christine M McIsaac, PA

  • Physician Assistant
  • East Setauket, NY
National Provider Identifier
1710656442
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
45 Research Way Ste 108
East Setauket, NY 11733-6401
Phone
(631) 941-2000
NPI assigned
Sep 7, 2021
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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 NU Primary

Addresses

Primary practice location

45 Research Way Ste 108
East Setauket, NY 11733-6401

Mailing address

45 Research Way Ste 108
East Setauket, NY 11733-6401
Phone (631) 941-2000

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
I20220315001623 NY Practitioner - Physician Assistant 2668867425 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027118NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 31, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients
North Suffolk Cardiology Associates PastSince Feb 1, 2022 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

45 Research Way
Ste 108
Setauket, NY 11733
Phone (631) 941-2704

101 Nicolls Rd
Rm 496
Stony Brook, NY 11794
Phone (808) 344-8324

Networks

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

Organizations & group practices 3

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1710656442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 108",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-941-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 108",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-941-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCISAAC",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.