Individual provider Active NPI

Anthony Michael Carlisi, M.D.

  • Internal Medicine Physician
  • Bethpage, NY
National Provider Identifier
1053472746
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
184172 Issued in NY
Practice address
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone
(516) 520-2745
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 184172 NY Primary

Addresses

Primary practice location

4295 Hempstead Tpke
Bethpage, NY 11714-5713

Mailing address

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 520-2745

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080220000346 NY Practitioner - Internal Medicine 3173607843 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22405 Jamaica Ave
Queens Village, NY 11428-2019
Phone (718) 571-9395

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
184172NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Feb 14, 2024 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Jun 1, 2014 Accepting new patients
Excel Urgent Care of Wantagh PLLC CurrentSince Sep 5, 2022 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 14, 2024 Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

4954 Merrick Rd
Massapequa Park, NY 11762
Phone (516) 308-7255

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

22405 Jamaica Ave
Queens Village, NY 11428
Phone (718) 571-9395

3430 Sunrise Hwy
Wantagh, NY 11793
Phone (516) 900-1600

Interoperability endpoints

  • Direct secure messaging: anthony.carlisi.1@2983.direct.athenahealth.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1053472746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4295 HEMPSTEAD TPKE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145713",
            "telephone_number": "516-520-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 HEMPSTEAD TPKE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145713",
            "telephone_number": "516-520-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISI",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "184172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.