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SHANTAE RODRIGUEZ PA
NPI 1902055650
Physician Assistant in Stony Brook, NY

Active since September 17, 2008PECOS EnrolledAccepts Medicare Assignment
STONY BROOK MEDICINE EM, 100 NICOLLS ROAD, HSC, LEVEL 4, ROOM 080, STONY BROOK, NY 11794(631) 444-2478(631) 444-3919 Get Directions Write a Review

NPPES record last updated: March 16, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shantae Rodriguez Pa NPPES

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

SHANTAE RODRIGUEZ PA (NPI 1902055650) is an individual physician assistant in Stony Brook, New York, licensed in New York (012566) and active in the NPI registry since September 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1902055650
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSHANTAE RODRIGUEZCredential: PA
Location AddressSTONY BROOK MEDICINE EM, 100 NICOLLS ROAD, HSC, LEVEL 4, ROOM 080Stony Brook, NY 11794-8350
Mailing AddressPo Box 1554Stony Brook, NY 11790-0988 · (631) 444-2478 · Fax (631) 444-3919
Phone(631) 444-2478
Fax(631) 444-3919
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateSeptember 17, 2008
Last NPPES UpdateMarch 16, 2017
✔ NPI 1902055650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 012566
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 012566 (NY)
STONY BROOK MEDICINE EM, Stony Brook, NY 11794
Open in Google Maps ↗

Other Identifiers 2

Other012566NY · License #
Other1079871Nccpa Cert.#

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shantae Rodriguez Pa 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 ID9830251909
PECOS Enrollment IDI20081224000164
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
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

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

MARY WERTHEIM NP
Nurse Practitioner (Adult Health)
STONY BROOK MEDICINE EM, 100 NICOLLS ROAD, HSC, LEVEL 4, ROOM 080
STONY BROOK, NY 11794
Suffolk County (631) 444-2478

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 Shantae Rodriguez's NPI number?

The NPI number for Shantae Rodriguez is 1902055650. It was assigned to this individual provider in the NPPES registry on September 17, 2008.

Where is Shantae Rodriguez located?

Shantae Rodriguez practices at Stony Brook Medicine Em 100 Nicolls Road, Hsc, Level 4, Room 080, Stony Brook, NY 11794. The listed phone number is (631) 444-2478.

What is Shantae Rodriguez's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Shantae Rodriguez enrolled in Medicare?

Yes. Shantae Rodriguez 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.

When was this NPI record last updated?

The NPPES record for Shantae Rodriguez was last updated on March 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.