Individual provider Active NPI

Dawn Roehrig-Martinez, PA

  • Physician Assistant
  • Westhampton Beach, NY
National Provider Identifier
1730255563
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005751-1 Issued in NY
Practice address
80 Old Riverhead Rd
Westhampton Beach, NY 11978-1401
Phone
(631) 288-7746
Fax
(631) 288-7111
NPI assigned
Nov 24, 2006
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
Physician Assistant 363A00000X 005751-1 NY Primary

Addresses

Primary practice location

80 Old Riverhead Rd
Westhampton Beach, NY 11978-1401

Mailing address

80 Old Riverhead Rd
Westhampton Beach, NY 11978-1401
Phone (631) 288-7746

Other names 1

  • Dawn Roehrig Former name

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
I20080225000574 NY Practitioner - Physician Assistant 3274617626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

301 E Main St
Bay Shore, NY 11706-8408

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

46 Brentwood Rd
Bay Shore, NY 11706-6924
Phone (631) 587-1800

Hospital & facility affiliations

  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005751-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Healthcare Inc. CurrentSince Oct 1, 2010 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
County of Suffolk Past Accepting new patients
County of Suffolk Past Accepting new patients

Locations

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

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Ste C101
Westbury, NY 11590

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730255563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 OLD RIVERHEAD RD",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119781401",
            "telephone_number": "631-288-7746",
            "fax_number": "631-288-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 OLD RIVERHEAD RD",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119781401",
            "telephone_number": "631-288-7746",
            "fax_number": "631-288-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHRIG-MARTINEZ",
        "first_name": "DAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005751-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "ROEHRIG",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westhampton Beach, NY

Sources for this page

Verify at the official NPI Registry.