Justin Michael Petrocelli, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Practice address

1615 Northern Blvd Ste 106
Manhasset, NY 11030-3033

Phone

(516) 365-2500

NPI assigned

Jun 19, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

New York Medical College, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Square Care Medical Group LLPGroup PAC ID 7012938434, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Merit-based Incentive Payment System (MIPS)

Final score

87.62 of 100Reported as group

Quality

88.76

Promoting interoperability

100

Improvement activities

40

Cost

69.99

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: justin.petrocelli.1@15987.direct.athenahealth.com

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.

• Square Care Medical Group, LLP

  • Obstetrics & Gynecology Physician
  • Woodbury, NY
  • NPI 1457392763
  Medicare reassignment Care Compare group
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  NPD (past)
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Obstetrics & Gynecology

  NPD (past)

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

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation
• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154558856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE STE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905114",
            "telephone_number": "516-226-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 NORTHERN BLVD STE 106",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303033",
            "telephone_number": "516-365-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCELLI",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Marie Pertoso
• Caroline Pessel, M.D.
• Peter J Lacorte O.D. P.C.
• Colleen Petrere, PA-C
• John Edward Petrizzo, DPT
• Jennifer Lauren Petrone, FNP-C
• Angelique Petropouleas, DO
• Jennifer Morgenstern Petruccelli
• Donald William Pettet III, DO
• Alexandra Rose Peyser, M.D.

• Obstetrics & Gynecology Physician in Manhasset, NY
• Providers in Manhasset, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.