Andrew De la Mata, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

68 Harris Bushville Rd
Monticello, NY 12701-3027

Phone

(845) 794-3300

NPI assigned

May 16, 2024

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crystal Run Healthcare Physicians LLPGroup PAC ID 6901792696, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Crystal Run Healthcare Physicians LLP

  • General Practice Physician
  • Middletown, NY
  • NPI 1952376410
  Medicare reassignment Care Compare group NPD
• Orange Emergency Services PC

  • Emergency Medicine Physician
  • Middletown, NY
  • NPI 1043589682
  Medicare reassignment
• Sullivan Emergency Services PC

  • Emergency Medicine Physician
  • Harris, NY
  • NPI 1528338480
  Medicare reassignment
• Crystal Run Healthcare Physicians LLP

  • Durable Medical Equipment & Medical Supplies
  • Monroe, NY
  • NPI 1558857425
  NPD

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

• Catskill Regional Medical Center

  dba CRMC Physician Services

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563

  Hospital

  Care Compare affiliation
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• Garnet Health Medical Center Catskills

  • Rural Acute Care Hospital
  • Harris, NY
  • NPI 1710977012
  Care Compare affiliation

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1811746381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HARRIS BUSHVILLE RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127013027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HARRIS BUSHVILLE RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127013027",
            "telephone_number": "845-794-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA MATA",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Davanzo
• Emily Ann Davies, OTR/L
• Anthony Davis
• Jolyon Davis
• Dba Sullivan Arc
• Michael Pietro Delrosso
• Jenny K Dembergh, PT
• Veronica Depolito, LCSW
• Jessica Destime
• Amos M Diaz

• Physician Assistant in Monticello, NY
• Providers in Monticello, 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 May 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.