Look up the most recent NPI and PECOS records

Tara Marie Igneri

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

This provider is enrolled in PECOS as TARA IGNERI.

Based on the most recent information from CMS, provider Tara Marie Igneri is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1326141219
Provider Type
Individual
Full Name
Igneri, Tara Marie
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
9/6/2006
Last Updated
2/24/2011

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

(718) 226-6964

Mailing Location

One Edgewater Street, Suite 723, Staten Island, NY 10305

(718) 226-4324

(718) 226-1039

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 011311 New York

Provider Identifiers

ID	Description	Issuer
ID 02886877	Description Medicaid	Issuer Unlisted New York

Tara Marie Igneri

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Anees, Insherah

Calcutta, Samantha

Lastella, Megan Marie

Martino, Lindsay

Cheung, Jason

Raineri, Caterina O

Vurmo, Elena

Sher, Maykl

Daniel, Prince

Lantowski, Agnieszka