Nicolas Mavromoustakos

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

026722 Issued in NY

Practice address

14 Birch Ave
Huntington, NY 11743-4655

Phone

(631) 662-5714

NPI assigned

Feb 24, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis-Downtown Hospital, Greenville, SC, CCN 420023

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmavromoustakos3071551@direct.bsmhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bon Secours Medical Group Greenville Specialty Care LLC

  • Cardiovascular Disease Physician
  • Greenville, SC
  • NPI 1821679580
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• Bon Secours Medical Group Greenville Specialty Care LLC

  • Orthopaedic Surgery Physician
  • Fountain Inn, SC
  • NPI 1760361174
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Francis Hospital Inc

  • Clinic/Center
  • Greenville, SC
  • NPI 1104052752

  Hospital

  Care Compare affiliation
• St Francis Hospital Inc

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1730123175
  Care Compare affiliation
• St Francis Hospital, Inc.

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1467496802
  Care Compare affiliation
• St Francis Hospital, Inc.

  • Clinical Medical Laboratory
  • Greenville, SC
  • NPI 1972127017

  Hospital

  Care Compare affiliation
• St. Francis Hospital Inc

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1023418035
  Care Compare affiliation
• St. Francis Hospital, Inc.

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1376899856
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1003440504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BIRCH AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BIRCH AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434655",
            "telephone_number": "631-662-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROMOUSTAKOS",
        "first_name": "NICOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2021-07-15",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Joan Mathews, PH.D. CCC. DIP.ED
• Jennifer Mathurin
• Melissa Mathurin
• Robert J Matlach, DDS
• Matthew Kassnove, DPM, PC
• Max Rudansky, MD & Jacques Winter MD, PC
• Joseph Edwin May, MD
• Virginija Mayer
• Corinne Mazzarella
• Alessandra Mazzola, LMT

• Physician Assistant in Huntington, NY
• Providers in Huntington, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.