Individual provider Active NPI

Tess Elizabeth Macqueen, PA-C

  • Physician Assistant
  • Ithaca, NY
National Provider Identifier
1861747388
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015751 Issued in NY
Practice address
2333 N Triphammer Rd Ste 203
Ithaca, NY 14850
Phone
(607) 257-1107
Fax
(607) 257-0369
NPI assigned
Jul 20, 2012
Last updated
Oct 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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 015751 NY Primary

Addresses

Primary practice location

2333 N Triphammer Rd Ste 203
Ithaca, NY 14850

Mailing address

2333 N Triphammer Rd Ste 203
Ithaca, NY 14850-1075
Phone (607) 257-1107

Other practice location 1

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4011

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
I20120831000403 NY Practitioner - Physician Assistant 3870740566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pine Point Medical PLLCGroup PAC ID 3678903762, 5 clinicians

Practice addresses (Care Compare)

3105 N Triphammer Rd
Suite 7
Lansing, NY 14882-8710
Phone (607) 533-0281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015751NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Emergency Physicians, LLP CurrentSince Aug 1, 2012 Accepting new patients
Pine Point Medical, PLLC CurrentSince Mar 2, 2020 Accepting new patients
Robert T. Horn, Jr., M.D. Past Accepting new patients

Locations

75 Remit Dr
Chicago, IL 60675

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

3105 N Triphammer Rd
Ste 7
Lansing, NY 14882
Phone (607) 533-0281

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21066/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tess.macqueen.1@21066.direct.athenahealth.com

Organizations & group practices 4

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.

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": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1861747388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 N TRIPHAMMER RD STE 203",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501075",
            "telephone_number": "607-257-1107",
            "fax_number": "607-257-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 N TRIPHAMMER RD STE 203",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-257-1107",
            "fax_number": "607-257-0369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dates Dr",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501342",
            "country_code": "US",
            "telephone_number": "607-274-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACQUEEN",
        "first_name": "TESS",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.