Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Tara Deitrick

Individual provider Certified Registered Nurse Anesthetist · NPI 1497855704

Tara Deitrick is registered under Certified Registered Nurse Anesthetist (CRNA) in Mineola, New York. Qualified in 1980, 46 years ago. Practices with Endoscopy Center of Long Island LLC, a 21-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
46
Licensed in
NY
In the registry since
2006
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Practice location Address checks out

259 1st St
Mineola, NY 11501-3957
Phone: (516) 741-0570
Fax: (516) 741-8276
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 9330 (NY)

Record details

NPI number1497855704
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 25, 2006
Last updated in NPPESNovember 29, 2017

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Group practice Endoscopy Center Of Long Island Llc — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients209
Services billed 209 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Endoscopy Center of Long Island LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 21 clinicians in the practice; 1 are shown here.

Other providers in Mineola