Individual provider Active NPI

Janet M. Faicco, F. N. P.

  • Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1053309781
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F332490 Issued in NY
Practice address
347 Edison St
Staten Island, NY 10306-3034
Phone
(718) 351-1136
Fax
(718) 667-9711
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F332490 NY Primary

Addresses

Primary practice location

347 Edison St
Staten Island, NY 10306-3034

Mailing address

97 New Dorp LN
Staten Island, NY 10306-2359
Phone (718) 876-6220

Other identifiers 1

IdentifierTypeStateIssuer
01911348MedicaidNY

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
I20040710000094 NY Practitioner - Nurse Practitioner 0345228961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F332490NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 23, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 23, 2022 Accepting new patients
Queens Replacement LLC Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

501 Seaview Ave
Staten Island, NY 10305
Phone (718) 667-4700

375 Seguine Ave
#2
Staten Island, NY 10309
Phone (718) 226-2287

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Interoperability endpoints

  • Direct secure messaging: janetfaicco@imspllc.allscriptsdirect.net

Organizations & group practices 3

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053309781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062359",
            "telephone_number": "718-876-6220",
            "fax_number": "718-876-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063034",
            "telephone_number": "718-351-1136",
            "fax_number": "718-667-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAICCO",
        "first_name": "JANET",
        "middle_name": "M.",
        "credential": "F. N. P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F332490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01911348",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.