Individual provider Active NPI

Anthony Ciricillo

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1194285916
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
324636 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(188) 878-5637
NPI assigned
Mar 20, 2019
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 324636 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

22 Morse PL
Belleville, NJ 07109-1555
Phone (201) 618-8772

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
I20231013001669 NY Practitioner - Family Practice 4981002151 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Resources IncGroup PAC ID 4486703352, 82 clinicians

Practice addresses (Care Compare)

1045 James St
Syracuse, NY 13203-2730
Phone 31547244711384

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324636NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Family Medicine Current Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Sep 25, 2023 Accepting new patients
St Joseph's Hospital Health Center Family Medicine CurrentSince Aug 21, 2023 Accepting new patients
St. Joseph's Pathology, PC Current Accepting new patients
Liberty Resources Inc. Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Aug 21, 2023 Accepting new patients
Liberty Resources, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Liberty Resources, Inc. CurrentSince Jan 6, 2025 Accepting new patients
St Anthony Regional Hospital and Nursing Home Current Accepting new patients
Onondaga Pastoral Counseling Center Past Accepting new patients

Locations

311 S Clark St
Carroll, IA 51401
Phone (712) 792-3581

405 S Clark St
Ste 100
Carroll, IA 51401
Phone (712) 792-1500

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

Interoperability endpoints

  • Direct secure messaging: aciricillo4038919@direct.trinity-health.org
  • Direct secure messaging: anthony.ciricillo.p1@direct.liberty-resources.nextgenshare.com
  • Direct secure messaging: alciricillo@direct.sarh.kobledirect.com

Organizations & group practices 10

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.

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1194285916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MORSE PL",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091555",
            "telephone_number": "201-618-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "188-878-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRICILLO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "324636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.