Individual provider Active NPI

Antonia Marie Greco, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1104712066
Registry record updated Oct 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034664 Issued in NY
Practice address
1 Campus Rd
Staten Island, NY 10301-4479
Phone
(718) 663-1078
NPI assigned
Jun 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 034664 NY Primary

Addresses

Primary practice location

1 Campus Rd
Staten Island, NY 10301-4479

Mailing address

1 Campus Rd
Staten Island, NY 10301-4479
Phone (718) 663-1078

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
I20260319002968 NY Practitioner - Physician Assistant 2668956483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034664NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Feb 10, 2026 Accepting new patients
North Shore-Lij Medical PC CurrentSince Feb 10, 2026 Accepting new patients

Locations

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Organizations & group practices 2

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760745600000",
    "number": "1104712066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAMPUS RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014479",
            "telephone_number": "718-663-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAMPUS RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014479",
            "telephone_number": "718-663-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECO",
        "first_name": "ANTONIA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.