Tatiana Ricketts, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

267740 Issued in NY

Practice address

1055 Stewart Ave
Bethpage, NY 11714-3596

Phone

(516) 938-0100

Fax

(516) 938-0120

NPI assigned

Feb 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: tviloria15932@nychhc.direct-ci.com
• FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

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.

• North Shore Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1396794574
  Medicare reassignment Care Compare group NPD
• Advantagecare Physicians PC

  dba AdvantageCare Physicians

  • General Practice Physician
  • New York, NY
  • NPI 1336578772
  Medicare reassignment NPD
• Advantagecare Physicians PC

  dba AdvantageCare Physicians Urgent Care

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1063954113
  NPD
• South Shore University Hospital

  • General Acute Care Hospital
  • Bay Shore, NY
  • NPI 1457369381
  NPD (past)

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1972843944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 STEWART AVE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143596",
            "telephone_number": "516-938-0100",
            "fax_number": "516-938-0120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96-10 Metropolitan Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113756625",
            "country_code": "US",
            "telephone_number": "718-459-0400",
            "fax_number": "718-670-6479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Marcus Ave",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110422057",
            "country_code": "US",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Broadway",
            "address_2": "Woodhull Medical & Mental Health Center",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11206",
            "country_code": "US",
            "telephone_number": "718-963-8000 x3129",
            "fax_number": "718-630-3122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 South Broadway",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "NY",
            "postal_code": "118015006",
            "country_code": "US",
            "telephone_number": "516-938-0100",
            "fax_number": "516-938-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "TATIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "267740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iwona Rawinis, MD
• Rebecca Levy-Bezalel, D.O., P.C.
• Lawrence Alexander Reduto, MD
• Irene Reilly, LCSW
• Nancy Marie Reyes, LCSW
• Stephanie Rose Ringbauer
• Doni Marie Rivas, D.O.
• Cristina Rivera
• Marisa Rizzi, ANP
• Rla Marketing, Inc.

• Obstetrics & Gynecology Physician in Bethpage, NY
• Providers in Bethpage, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.