Individual provider Active NPI

Antonio Picon, M.D.,

  • Colon & Rectal Surgery Physician
  • Staten Island, NY
National Provider Identifier
1154353100
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
002594-1 Issued in NY
Practice address
256 Mason Ave
Staten Island, NY 10305-3408
Phone
(718) 226-6398
Fax
(718) 226-1247
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 002594-1 NY Primary

Addresses

Primary practice location

256 Mason Ave
Staten Island, NY 10305-3408

Mailing address

256 Mason Ave
Staten Island, NY 10305-3408
Phone (718) 226-6398

Other identifiers 1

IdentifierTypeStateIssuer
02799622MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200625003180 CT Practitioner - Surgical OncologyPractitioner - General Surgery 6305940800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

29 Hospital PLZ
Suite 603
Stamford, CT 06902-3602
Phone (203) 276-5959

Hospital & facility affiliations

  • Stamford Hospital Hospital, Stamford, CT, CCN 070006

Merit-based Incentive Payment System (MIPS)

Final score
86.6 of 100Reported as group
Quality
84.86
Promoting interoperability
99
Improvement activities
40
Cost
71.31

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002594-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc CurrentSince Aug 3, 2020 Accepting new patients
Bimc Faculty Practice Past Accepting new patients

Locations

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

29 Hospital Plz
Ste 603
Stamford, CT 06902
Phone (203) 276-2002

Interoperability endpoints

  • Direct secure messaging: apicon24804@stamfordhealth.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1154353100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6398",
            "fax_number": "718-226-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6398",
            "fax_number": "718-226-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICON",
        "first_name": "ANTONIO",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "002594-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02799622",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.