1. Home
  2. Directory
  3. New York
  4. Mineola
  5. Nurse Anesthetist Certified Registered
  6. NPI Profile

TARA DEITRICK
NPI 1497855704
Nurse Anesthetist, Certified Registered in Mineola, NY

Active since September 25, 2006Accepts Medicare Assignment
259 1ST ST, MINEOLA, NY 11501(516) 741-0570(516) 741-8276 Get Directions Write a Review

NPPES record last updated: November 29, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tara Deitrick NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA DEITRICK (NPI 1497855704) is an individual nurse anesthetist, certified registered in Mineola, New York, licensed in New York (9330) and active in the NPI registry since September 2006. She is a graduate of Other (1980).

NPPES Registry Identity

NPI1497855704
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameTARA DEITRICK
Location Address259 1ST STMineola, NY 11501-3957
Mailing Address17 Kenwood RdGarden City, NY 11530-3034 · (516) 248-1420
Phone(516) 741-0570
Fax(516) 741-8276
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateSeptember 25, 2006
Last NPPES UpdateNovember 29, 2017
✔ NPI 1497855704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in NY · 9330
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
259 1ST ST, Mineola, NY 11501
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tara Deitrick is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123200375
PECOS Enrollment IDI20110309000041

Medicare Billing Reassignments

2

Medicare enrollment records show Tara Deitrick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Endoscopy Center Of Long Island LLC
1.9 mi
Endoscopy
711 STEWART AVE, SUITE 114
Garden City, NY 11530
  • Reassigned Medicare billing, New York enrollment
  • 65 clinicians in this Medicare group
NPI 1770718009 (516) 227-3254
North Shore - Lij Anesthesiology, PC
31 mi
Anesthesiology
480 BEDFORD RD BLDG B
Chappaqua, NY 10514
  • Reassigned Medicare billing, New York enrollment
  • 1,406 clinicians in this Medicare group
NPI 1417401266 (914) 666-8866

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for exam of colon using an endoscope 00812
Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.
112 services112 patients
Anesthesia for procedure on small and large bowel using an endoscope 00813
Anesthesia for an endoscopic procedure on the small and large bowel ensures comfort and relaxation during the procedure. It involves administering medicine to help you sleep or feel drowsy. This allows the doctor to examine your bowels without causing you discomfort or pain.
52 services52 patients
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
36 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSY MILLER M.D.
Anesthesiology
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 741-0570
GINA CARUCCI
Physician Assistant (Medical)
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 663-0333
DR. CHRISTIAN GIGANTE MD
Student in an Organized Health Care Education/Training Program
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 663-8794
CHRISTOPHER PETILLO
Student in an Organized Health Care Education/Training Program
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 663-0333
JOHN ANTHONY DINELLI MD
Student in an Organized Health Care Education/Training Program
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 663-0333
MANISHA SAKORE MD
Pediatrics (Neonatal-Perinatal Medicine)
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 663-3853
DR. LAWRENCE SCHEINBERG M.D.
Anesthesiology
259 1ST ST
MINEOLA, NY 11501
Nassau County (516) 663-0333
DR. KIM ANN RUTHERFORD M.D.
Pediatrics (Pediatric Emergency Medicine)
259 1ST ST
MINEOLA, NY 11501
Nassau County (717) 531-8955

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Deitrick's NPI number?

The NPI number for Tara Deitrick is 1497855704. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Where is Tara Deitrick located?

Tara Deitrick practices at 259 1st St, Mineola, NY 11501. The listed phone number is (516) 741-0570.

What is Tara Deitrick's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Tara Deitrick enrolled in Medicare?

Yes. Tara Deitrick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Tara Deitrick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tara Deitrick reassigns Medicare benefits to 2 organizations: Endoscopy Center Of Long Island LLC (Garden City, NY) and North Shore - Lij Anesthesiology, PC (Chappaqua, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tara Deitrick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tara Deitrick was last updated on November 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.