Individual provider Active NPI

Andrea Zullo, CRNA

  • Certified Registered Nurse Anesthetist
  • Syosset, NY
National Provider Identifier
1275515421
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
385453-01 Issued in NY
Practice address
221 Jericho Tpke
Syosset, NY 11791-4515
Phone
(516) 496-6447
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3854531 NY
Certified Registered Nurse Anesthetist 367500000X 385453-01 NY Primary

Addresses

Primary practice location

221 Jericho Tpke
Syosset, NY 11791-4515

Mailing address

68 South Service Road
Suite 350
Melville, NY 11747-2358
Phone (516) 945-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041129000522 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749245033 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
3854531NYMDRegistered Nurse
385453-01NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Anesthesia Physicians LLP CurrentSince Aug 10, 2013 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Feb 28, 2019 Accepting new patients
Quality Medical Management Corp Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Office Based Anesthesia LLC CurrentSince Jul 4, 2023 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Nov 1, 2017 Accepting new patients
Long Island Digestive Endoscopy Center, LLC CurrentSince Apr 18, 2014 Accepting new patients
Suffolk Anesthesiology Associates, PC CurrentSince Sep 1, 2009 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

601 Suffolk Ave
Brentwood, NY 11717
Phone (631) 231-4384

28 Research Way
East Setauket, NY 11733
Phone (631) 380-2710

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

975 Stewart Ave
Garden City, NY 11530
Phone (516) 222-8600

560 Northern Blvd
Ste 203
Great Neck, NY 11021
Phone (516) 482-0600

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

1324 Motor Pkwy
Ste 101
Islandia, NY 11749
Phone (516) 850-8143

3636 33rd St
Ste 204
Long Island City, NY 11106
Phone (631) 446-1190

1895 Walt Whitman Rd
Ste 10
Melville, NY 11747
Phone (631) 293-9700

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

2001 Marcus Ave
Ste N18
New Hyde Park, NY 11042
Phone (516) 775-7770

300 Community Dr
Plandome, NY 11030

1110 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 476-9100

1500 Route 112
Bldg 5
Port Jefferson Station, NY 11776
Phone (631) 470-1450

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

1500 William Floyd Pkwy
Shirley, NY 11967
Phone (631) 205-0800

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

989 W Jericho Tpke
Smithtown, NY 11787
Phone (631) 864-5600

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 7

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1275515421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 SOUTH SERVICE ROAD",
            "address_2": "SUITE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472358",
            "telephone_number": "516-945-3000",
            "fax_number": "516-945-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 JERICHO TPKE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914515",
            "telephone_number": "516-496-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZULLO",
        "first_name": "ANDREA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "3854531",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "385453-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.