Individual provider Active NPI

Christy Janes, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Deer Park, NY
National Provider Identifier
1881993830
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014410 Issued in NY
Practice address
16 Van Cott Road
Deer Park, NY 11729
Phone
(631) 274-0777
Fax
(631) 274-9499
NPI assigned
Mar 16, 2011
Last updated
Mar 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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 014410 NY Primary

Addresses

Primary practice location

16 Van Cott Road
Deer Park, NY 11729

Mailing address

16 Van Cott Road
Deer Park, NY 11729
Phone (631) 274-0777

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
I20120723000489 NY Practitioner - Physician Assistant 6800052655 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fulton Medical PCGroup PAC ID 8527201540, 19 clinicians

Practice addresses (Care Compare)

60 Queens St
Suite 100
Syosset, NY 11791-3058
Phone (631) 271-9151

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as group
Quality
79.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014410NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Oct 1, 2017 Accepting new patients
Mercy Medical Center CurrentSince Oct 1, 2017 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Feb 1, 2015 Accepting new patients
Island Medical Physicians, PC Past Accepting new patients
Hematology and Oncology of Li PLLC Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Organizations & group practices 11

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": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1881993830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 VAN COTT ROAD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "11729",
            "telephone_number": "631-274-0777",
            "fax_number": "631-274-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 VAN COTT ROAD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "11729",
            "telephone_number": "631-274-0777",
            "fax_number": "631-274-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANES",
        "first_name": "CHRISTY",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

Verify at the official NPI Registry.