Individual provider Active NPI

Michelle Amy Frollo Tetu, PA

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1982055893
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019758 Issued in NY
Practice address
211 Church St
Saratoga Springs, NY 12866-1003
Phone
(518) 587-1141
Fax
(518) 587-1152
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 019758 NY Primary

Addresses

Primary practice location

211 Church St
Saratoga Springs, NY 12866-1003

Mailing address

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 587-1141

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
I20160920000819 NY Practitioner - Physician Assistant 7113182437 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019758NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince May 1, 2017 Accepting new patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince May 1, 2017 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Jun 1, 2018 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Jun 1, 2018 Accepting new patients
Saratoga Hospital Current Accepting new patients

Locations

112 Charlton Rd
Charlton, NY 12019
Phone (518) 399-7723

2911 State Route 9
Ste 1
Malta, NY 12020
Phone (518) 363-8815

6 Medical Park Dr
Malta, NY 12020
Phone (518) 289-2020

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

Interoperability endpoints

  • Direct secure messaging: mtetu102424@albanymed.direct-ci.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1982055893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661003",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661003",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETU",
        "first_name": "MICHELLE",
        "middle_name": "AMY FROLLO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.