Shantae Rodriguez, PA is a
Physician Assistant physician based in Stony Brook, New York. Shantae Rodriguez is licensed to practice in New York (license number 012566) and her current practice location is Stony Brook Medicine Em, 100 Nicolls Road, Hsc, Level 4, Room 080, Stony Brook, New York. She can be reached at her office (for appointments etc.) via phone at
(631) 444-2478.
NPI number for Shantae Rodriguez is 1902055650 and her current mailing address is Po Box 1554, Stony Brook, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1902055650.
Physician's Profile
| Full Name | Shantae Rodriguez |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Location | Stony Brook Medicine Em, Stony Brook, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1902055650
- Provider Enumeration Date: 09/17/2008
- Last Update Date: 03/16/2017
Medical Identifiers
Medical identifiers for Shantae Rodriguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902055650 | NPI | - | NPPES |
| 012566 | Other | NY | LICENSE # |
| 1079871 | Other | | NCCPA CERT.# |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 012566 (New York) | Secondary |
| 363A00000X | Physician Assistant | 012566 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shantae Rodriguez is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shantae Rodriguez, PA
Po Box 1554,
Stony Brook, NY 11790-0988
Ph: (631) 444-2478 | Shantae Rodriguez, PA
Stony Brook Medicine Em, 100 Nicolls Road, Hsc, Level 4, Room 080,
Stony Brook, NY 11794-8350
Ph: (631) 444-2478 |
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