Vincent Gerard Alestra, AGPCNP, RN
Individual provider Active NPI Nurse Practitioner · Smithtown, NY
NPI 1760004402 · NPPES record last updated Mar 14, 2024
Key facts
- NPI
- 1760004402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 309867 (NY)
- Practice address
- 994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211 - Phone
- (631) 543-1440
- NPI assigned
- May 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- State University of New York at Stony Brook, School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Timothy D. Groth MD PC
Practice addresses (Care Compare)
994 W Jericho Tpke
Suite 104
Smithtown, NY 11787-3211
Phone (631) 543-1440
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.89 of 100
- Quality
- 87.77
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 68.55
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210423001658 | NY | Practitioner - Nurse Practitioner | 3173935210 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309867 | NY | MD | Nurse Practitioner |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Timothy D. Groth MD PC | Current |
Accepting new patients |
Locations
1500 Middle Country Rd
Centereach, NY 11720
Phone (631) 716-8758
285 Sills Rd
Bldg 9D
East Patchogue, NY 11772
Phone (631) 319-6107
1111 Broadhollow Rd
Ste 114
Farmingdale, NY 11735
Phone (516) 336-8659
81 N Broadway
Hicksville, NY 11801
Phone (516) 827-7400
184 Old Country Rd
Mineola, NY 11501
Phone (516) 294-4457
1061 N Broadway
Ste 2
North Massapequa, NY 11758
Phone (516) 420-4300
410 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 642-1100
100 N Centre Ave
Ste 302
Rockville Centre, NY 11570
1500 William Floyd Pkwy
Ste 201
Shirley, NY 11967
Phone (631) 205-0800
1500 William Floyd Pkwy
Ste 203
Shirley, NY 11967
50 New York Ave
#25A
Smithtown, NY 11787
Phone (631) 309-5222
994 W Jericho Tpke
Ste 104
Smithtown, NY 11787
Phone (516) 400-3595
1111 Route 110
South Farmingdale, NY 11735
Phone (267) 642-4091
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- vincentalestra_35472@timothygrothmdpc.omnimddirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 309867 | NY | Yes |
Addresses
Primary practice location
994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Mailing address
994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | VincentAlestra_35472@timothygrothmdpc.omnimddirect.com |
Other providers in Smithtown, NY
- Lindsay Albanese
- Jane Albertson Kelly
- Michelle Marie Alcalde
- Rosenie Alce
- Karen Ann Aldrich
- Alex a. Rothfeld MD PC
- Alexa Medical Supply
- Jennifer Jane Alfano
- Alfred Belding MD & John Franco MD & F Gleason MD & J Dragone MD
- Ece Algur
All providers in Smithtown, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.