Andrew J Ribaudo, RPA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

54 Woodville Rd
Shoreham, NY 11786-1331

Phone

(631) 929-1256

Fax

(631) 929-8313

NPI assigned

Nov 2, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

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

Credentials

Physician Assistant

Practice roles

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.

• Peconic Bay Primary Medical Care

  dba Same

  • Internal Medicine Physician
  • Mattituck, NY
  • NPI 1487620613
  Medicare reassignment
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  NPD (past)
• Sound Family Medicine PC

  • Family Medicine Physician
  • Shoreham, NY
  • NPI 1205022837
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770574246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OLD COUNTRY RD STE 2",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012121",
            "telephone_number": "631-298-4479",
            "fax_number": "631-591-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 WOODVILLE RD",
            "city": "SHOREHAM",
            "state": "NY",
            "postal_code": "117861331",
            "telephone_number": "631-929-1256",
            "fax_number": "631-929-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBAUDO",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "RPA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Phillips, L-MSW
• Nancy Dorothy Pierro, LMHC
• Mark Paul Portuese
• Katherine Prisco
• Barbara I Reichert, RN
• Kristen Robertson, LPN
• Rocky Point Fire District
• Timothy Roy, R.N.
• George Richard Ruggiero, DO
• Eric Brett Salmonson, DDS

• Physician Assistant in Shoreham, NY
• Providers in Shoreham, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.