Individual provider Active NPI

Alyssa Costantino

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1275402943
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2177 Victory Blvd
Staten Island, NY 10314-6603
Phone
(718) 370-3730
NPI assigned
Oct 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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 Primary

Addresses

Primary practice location

2177 Victory Blvd
Staten Island, NY 10314-6603

Mailing address

447 Sycamore St
Staten Island, NY 10312-5016

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
I20260325000486 NY Practitioner - Physician Assistant 1557845856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2177 Victory Blvd
Staten Island, NY 10314-6603

4143 Richmond Ave
Suite 1
Staten Island, NY 10312-5637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1761868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1275402943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 SYCAMORE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146603",
            "telephone_number": "718-370-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANTINO",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-31",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.