Individual provider Active NPI

Richard Maggio, M.D.

  • Specialist
  • Staten Island, NY
National Provider Identifier
1205939998
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
176972-1 Issued in NY
Practice address
1086 Forest Ave FL 3
Staten Island, NY 10310-2405
Phone
(347) 774-8386
Fax
(718) 981-4261
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA58803 NJ
Specialist 174400000X 176972-1 NY Primary

Addresses

Primary practice location

1086 Forest Ave FL 3
Staten Island, NY 10310-2405

Mailing address

1086 Forest Ave FL 3
Staten Island, NY 10310-2405
Phone (347) 774-8386

Other identifiers 1

IdentifierTypeStateIssuer
02951426MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080428000152 NY Practitioner - Urology 7214927417 Reassigns benefits to 2 organizations
Practice locations: Staten Island, NY
I20170804003070 NJ Practitioner - Urology 7214927417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
New York Medical College, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

355 Bard Ave
Staten Island, NY 10310-1664

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

Hospital & facility affiliations

  • Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028
  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA58803NJMDSpecialist
176972-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Genitourinary Surgeons of New Jersey PA CurrentSince Jul 18, 1997 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Jun 1, 2015 Accepting new patients
Amboy Medical Practice PC CurrentSince Jan 1, 2015 Accepting new patients
Amboy Medical Practice PC CurrentSince Jan 1, 2015 Accepting new patients
Sovereign Medical Group LLC CurrentSince Jun 1, 2015 Accepting new patients
Richmond University Medical Center Past Accepting new patients

Locations

579A Cranbury Rd
Ste 105
East Brunswick, NJ 08816
Phone (732) 390-8700

85 Harristown Rd
Ste 200
Glen Rock, NJ 07452
Phone (201) 444-4526

211 Courtyard Dr
Hillsborough, NJ 08844
Phone (908) 685-0080

631 Grand St
Ste 2400
Jersey City, NJ 07304
Phone (201) 636-6784

631 Grand St
Ste 21
Jersey City, NJ 07304

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

2071 Clove Rd
Ste J
Staten Island, NY 10304
Phone (347) 774-8386

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

1086 Forest Ave
Ste 3
Staten Island, NY 10310
Phone (347) 774-8386

1200 South Ave
Ste 301
Staten Island, NY 10314
Phone (718) 370-1400

2071 Clove Rd
#J
Staten Island, NY 10304
Phone (201) 855-8301

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

1200 South Ave
Staten Island, NY 10314
Phone (718) 370-1400

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: richard.maggio.1@19656.direct.athenahealth.com

Organizations & group practices 6

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 2

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1205939998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FOREST AVE FL 3",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102405",
            "telephone_number": "347-774-8386",
            "fax_number": "718-981-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FOREST AVE FL 3",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102405",
            "telephone_number": "347-774-8386",
            "fax_number": "718-981-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIO",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA58803",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "176972-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02951426",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.