Shantae Rodriguez, PA is a medicare enrolled "Physician Assistant" physician in Stony Brook, New York. She graduated from medical school in 2008 and has 18 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Urgent Care Of New York Pllc and her current practice location is
Stony Brook Medicine Em, 100 Nicolls Road, Hsc, Level 4, Room 080, Stony Brook, New York. You can reach out to her office (for appointments etc.) via phone at
(631) 444-2478.
Shantae Rodriguez is licensed to practice in New York (license number 012566) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902055650.
Physician's Profile
| Full Name | Shantae Rodriguez |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 18 Years |
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| Location | Stony Brook Medicine Em, Stony Brook, New York |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shantae Rodriguez graduated from medical school in 2008
NPI Data:
- NPI Number: 1902055650
- Provider Enumeration Date: 09/17/2008
- Last Update Date: 03/16/2017
Medicare PECOS Information:
- PECOS PAC ID: 9830251909
- Enrollment ID: I20081224000164
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 |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Urgent Care Of New York Pllc | 2466816525 | 11 |
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
enrolled with medicare and thus, if eligible, can 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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