Individual provider Active NPI

Marco Antonio Veintimilla Jr., P.A.

  • Physician Assistant
  • Middletown, NY
National Provider Identifier
1942625504
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017392 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-7575
NPI assigned
Feb 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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 017392 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Other practice location 1

722 W 168th St
New York, NY 10032-3727
Phone (212) 305-2500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mveintimilla73708@direct.garnethealth.org Direct Garnet Health Doctors PC

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
I20240501001008 NY Practitioner - Physician Assistant 0345680823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Pittsburgh School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garnet Health Doctors PCGroup PAC ID 8628293545, 165 clinicians

Practice addresses (Care Compare)

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Hospital & facility affiliations

  • Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

National Provider Directory

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: mav9126@direct.nyp.org

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 6

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": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1942625504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "722 W 168th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323727",
            "country_code": "US",
            "telephone_number": "212-305-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEINTIMILLA",
        "first_name": "MARCO",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mveintimilla73708@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.