Individual provider Active NPI

Irene Petrocelli

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1053039701
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F432390-01 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2000
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F432390-01 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

40 Birch LN
Short Hills, NJ 07078-3219
Phone (347) 677-4236

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ip2373@cumc.columbia.edu Direct Columbia University Medical Center

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230316002008 NY Practitioner - Nurse Practitioner 8325412281 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.79 of 100Reported as group
Quality
80.63
Improvement activities
40
Cost
49.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F432390-01NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Neurology Group CurrentSince Nov 14, 2022 Accepting new patients
Mskcc Surgery Group CurrentSince Nov 14, 2022 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Nov 14, 2022 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Nov 14, 2022 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Nov 14, 2022 Accepting new patients
Mskcc Radiology Group CurrentSince Nov 14, 2022 Accepting new patients
Memorial Anesthesiology Group CurrentSince Nov 14, 2022 Accepting new patients
Memorial Cardiopulmonary Group CurrentSince Nov 14, 2022 Accepting new patients
Memorial Infectious Disease Group CurrentSince Nov 14, 2022 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Nov 14, 2022 Accepting new patients
Memorial Clinical Physiology Group CurrentSince Nov 14, 2022 Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ipetrocelli29915@mskcc.direct-ci.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1053039701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BIRCH LN",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070783219",
            "telephone_number": "347-677-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCELLI",
        "first_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F432390-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ip2373@cumc.columbia.edu",
            "affiliation": "Y",
            "endpointDescription": "professional email",
            "affiliationName": "Columbia University Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Phone",
            "address_1": "161 Fort Washington Ave Fl 12",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.