PATRICIA JACQUALINE ZUPAN (NPI# 1245781467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245781467 |
| Entity Type | Individual |
| Full Name | PATRICIA JACQUALINE ZUPAN |
| Credential | P.A. |
| Practice Address |
1801 Black River Blvd N Rome NY 13440-2427 |
| Practice Telephone | 3153373770 |
| Practice Fax Number | 3153375380 |
| Mailing Telephone | 3153373770 |
| Mailing Fax Number | 3153375380 |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 020125 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NY STATE LICENSE | 020125 | 01 |
| Street Address |
1801 BLACK RIVER BLVD N |
| City | ROME |
| State | NY |
| Zip Code | 13440-2427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730151507 | Gibran Tallim | Family Medicine | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-02-06 |
| 1164083259 | Mona Lisa Smith | Nurse Practitioner | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2019-06-27 |
| 1174017297 | Diane P Clute | Nurse Practitioner | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2018-06-21 |
| 1275930422 | Olubukola T Adeyeye | Pediatrics | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2014-12-02 |
| 1770816688 | Gulnara Rubinshteyn | Pediatrics | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2009-09-09 |
| 1659506111 | Desmond Francis | Internal Medicine | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2009-05-27 |
| 1093974511 | Reo Malachi Peniston | Family Medicine | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2008-06-09 |
| 1295890143 | Edwin A Vera | Nurse Practitioner | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-12-22 |
| 1932118684 | Adrienne Michelle Smith | Physician Assistant | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-08-05 |
| 1447280508 | M Shane Angleton | Physician Assistant | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-07-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409966 | Jamie Marcinkowski | Nurse Practitioner | 1617 N James Street, Suite 100, Rome, NY 13440 | 2020-08-28 |
| 1205452810 | Nichole Elizabeth Pollard | Optometrist | 1320 Floyd Ave, Suite 1, Rome, NY 13440 | 2020-06-19 |
| 1235750662 | Nicole Schrader | Social Worker | 7214 Bunal Blvd, Rome, NY 13440 | 2020-04-27 |
| 1457908212 | Darlene A. Sherman | Technician | 101 Glen Road S., Rome, NY 13440 | 2019-08-26 |
| 1841846847 | Delores A Smith | Technician | 7374 Davis Road, Rome, NY 13440 | 2019-08-15 |
| 1609342807 | Kent A Myers | Occupational Therapist | 200 West Dominic St, Rome, NY 13440 | 2018-10-16 |
| 1013376870 | Bonnie Flansburg | Physical Therapy Assistant | 101 W Liberty Street, Rome, NY 13440 | 2016-02-22 |
| 1760888689 | Ashley Elizabeth Bloomquist | Pharmacist | 808 West Chestnut Street, Rome, NY 13440 | 2014-11-05 |
| 1902231483 | Stephanie Ostalkiewicz | Licensed Practical Nurse | 701 Camp Street, Rome, NY 13440 | 2013-09-04 |
| 1992142251 | Tammy S. Guiliano | Registered Nurse | 401 Turin Street, The New York State School for The Deaf, Rome, NY 13440 | 2013-05-28 |
| Find all providers in zip 13440 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518587781 | Chandler Holcombe | Physician Assistant | 100 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2020-04-17 |
| 1609400886 | Morgan Elise Benson Baker | Physician Assistant | 123 Three Rivers Dr Ne, Rome, GA 30161-2300 | 2020-02-26 |
| 1548805401 | Mallory Elizabeth Osborne | Physician Assistant | 330 Turner Mccall Blvd Sw, Rome, GA 30165-5630 | 2019-11-14 |
| 1710522933 | William Edward Johnson | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-11-12 |
| 1225670532 | Caleb Elisha Etheridge | Physician Assistant | 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 | 2019-10-09 |
| 1659934321 | Tara Simonson | Physician Assistant | 310 W 10th St Ne, Rome, GA 30165-2639 | 2019-04-18 |
| 1255805180 | Amanda Lynn Preteroti | Physician Assistant | 504 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-01-14 |
| 1528535036 | Jaskirt Kaur Chahal | Physician Assistant | 1617 N James St, Rome, NY 13440-2852 | 2018-11-01 |
| 1205311131 | Austin James Malcom | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2018-09-26 |
| 1215439286 | Swaraj Suhas Hublikar | Physician Assistant | 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 | 2018-03-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.