Active NPI
Anthony Massimillo, M.D.
- Gastroenterology Physician
- Mineola, NY
National Provider Identifier
1043277692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 169701
- Practice address
- 300 Old Country Rd Ste 31
Mineola, NY 11501-4112 - Phone
- (516) 294-9380
- Fax
- (516) 294-5351
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 169701 | NY | Primary |
Addresses
Primary practice location
300 Old Country Rd Ste 31
Mineola, NY 11501-4112
Mailing address
300 Old Country Rd Ste 31
Mineola, NY 11501-4112
Phone (516) 294-9380
Other practice location 1
901 Stewart Ave
Suite 235
Garden City, NY 11530-4893
Phone (516) 742-5252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Old Country Rd
Suite 31
Mineola, NY 11501-4112
Phone (516) 294-9380
Hospital & facility affiliations
- NYU Langone Hospitals
- North Shore University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 28 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 28 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 169701 | NY | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients |
Locations
300 Old Country Rd
Ste 31
Mineola, NY 11501
Phone (516) 294-9380
300 Community Dr
Plandome, NY 11030
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- anthonymassimillo@nslijmedgr.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1043277692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 OLD COUNTRY RD STE 31",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115014112",
"telephone_number": "516-294-9380",
"fax_number": "516-294-5351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 OLD COUNTRY RD STE 31",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115014112",
"telephone_number": "516-294-9380",
"fax_number": "516-294-5351"
}
],
"practiceLocations": [
{
"address_1": "901 Stewart Ave",
"address_2": "Suite 235",
"address_purpose": "LOCATION",
"city": "Garden City",
"state": "NY",
"postal_code": "115304893",
"country_code": "US",
"telephone_number": "516-742-5252",
"fax_number": "516-742-7623",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MASSIMILLO",
"first_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "169701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.