Individual provider Active NPI

Theresa M Gentile, RPA-C

  • Physician Assistant
  • Woodbury, NY
National Provider Identifier
1841418480
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006482 Issued in NY
Practice address
45 Crossways Park Dr W
Woodbury, NY 11797-2037
Phone
(516) 992-4568
NPI assigned
Apr 20, 2007
Last updated
Feb 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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 006482 NY Primary

Addresses

Primary practice location

45 Crossways Park Dr W
Woodbury, NY 11797-2037

Mailing address

6011 251St St
Little Neck, NY 11362-2433
Phone (917) 748-4507

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
I20120117000351 NY Practitioner - Physician Assistant 8527235480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

1728 Sunrise Hwy
Merrick, NY 11566-3745
Phone (516) 992-4700

36 Lincoln Ave
Rockville Centre, NY 11570-5768
Phone (516) 536-2800

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
006482NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC Physician Assistant CurrentSince Jan 1, 2018 Accepting new patients
True North Medical Group PC CurrentSince Jan 1, 2018 Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

1728 Sunrise Hwy
Merrick, NY 11566
Phone (516) 992-4700

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

45 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 422-8080

Networks

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

Interoperability endpoints

  • Direct secure messaging: theresagentile@nslijmedgr.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1841418480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 251ST ST",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622433",
            "telephone_number": "917-748-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CROSSWAYS PARK DR W",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972037",
            "telephone_number": "516-992-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.