Mary Devine, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006111 Issued in NY

Practice address

2201 Hempstead Tpke
Internal Box 42
East Meadow, NY 11554-1859

Phone

(516) 572-6131

Fax

(516) 572-5793

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891856852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 JEFFERSON AVE",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117984021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "address_2": "INTERNAL BOX 42",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6131",
            "fax_number": "516-572-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "MARY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "006111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mireille Desgranges Seme, M.D.
• Rucha Deshpande
• Marie-Laure Desormeaux, M.D.
• Rose Desrosiers, LPN
• Priscilla Detweiler
• Vikramjeet Singh Dhillon
• Jovana Dias, PA-C
• Vivien Diaz-Barrios, M.S., CGC
• Jose David Diaz
• Rachael Dick, MD

• Medical Physician Assistant in East Meadow, NY
• Providers in East Meadow, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.