Doreen Delaney, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0062761 Issued in NY

Practice address

1110 Hallock Ave
Port Jefferson Station, NY 11776-2048

Phone

(631) 476-9100

Fax

(631) 476-4919

NPI assigned

Jul 17, 2006

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Suffolk Vascular Associates, PLLC

  • Vascular Surgery Physician
  • Port Jefferson Station, NY
  • NPI 1720059926
  Medicare reassignment

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1992723167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762048",
            "telephone_number": "631-476-9100",
            "fax_number": "631-476-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762048",
            "telephone_number": "631-476-9100",
            "fax_number": "631-476-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANEY",
        "first_name": "DOREEN",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "0062761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05749940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Friedland-Perez, LCSW, P.C.
• Susan J Day
• Courtney Dayton, LMFT
• Matias M Dcosta, MD
• Deepkeep Group Incorporated
• John Paul Delirio, PA-C
• Christianne Dellaratta, OPTICIAN
• Shannon Dawn Deluca, P.T.
• Nicole Delvecchio, NP
• Julie Demartini, O.D.

• Surgical Physician Assistant in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.