Individual provider Active NPI

Claudio Ginebra, RPA-C

  • Physician Assistant
  • Medford, NY
National Provider Identifier
1821350786
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015636 Issued in NY
Practice address
96 Rustic Ave
Medford, NY 11763-4448
Phone
(631) 495-4694
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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 015636 NY Primary

Addresses

Primary practice location

96 Rustic Ave
Medford, NY 11763-4448

Mailing address

96 Rustic Ave
Medford, NY 11763-4448
Phone (631) 495-4694

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
I20120905000614 NY Practitioner - Physician Assistant 6305093824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Home Medical Services PLLCGroup PAC ID 2062753320, 3 clinicians
Preferred Professional Medical Care PCGroup PAC ID 9739359027, 14 clinicians

Practice addresses (Care Compare)

3505 Veterans Memorial Hwy
Suite C
Ronkonkoma, NY 11779-7613
Phone (631) 676-7656

Hospital & facility affiliations

  • Tender Loving Care, an Amedisys Company Home health agency, Medford, NY, CCN 337260

Merit-based Incentive Payment System (MIPS)

Final score
24.88 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
82.94

National Provider Directory

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

Organizations & group practices 2

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 1

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1821350786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 RUSTIC AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634448",
            "telephone_number": "631-495-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 RUSTIC AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634448",
            "telephone_number": "631-495-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINEBRA",
        "first_name": "CLAUDIO",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.