Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Jillian Marie Peragallo

Individual provider Physician Assistant · NPI 1376944231

Mrs. Jillian Marie Peragallo is a Physician Assistant in Smithtown, New York. Qualified in 2014, 12 years ago. Practices with Timothy D. Groth MD PC, a 44-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone: (631) 543-1440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 018142 (NY)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1376944231
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 10, 2014
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Timothy D. Groth Md Pc — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Smithtown