Individual provider Active NPI

Jeffrey M. Nicastro, MD

  • Surgical Critical Care Physician
  • Danbury, CT
National Provider Identifier
1285611178
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
36193 Issued in CT
Practice address
111 Osborne St Ste 209
Danbury, CT 06810-6000
Phone
(203) 739-7131
Fax
(203) 739-1554
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 179518 NY
Surgical Critical Care Physician 2086S0102X 36193 CT Primary

Addresses

Primary practice location

111 Osborne St Ste 209
Danbury, CT 06810-6000

Mailing address

111 Osborne St
Danbury, CT 06810-6000
Phone (203) 739-7131

Other identifiers 1

IdentifierTypeStateIssuer
01867858MedicaidNY

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
I20060504001009 NY Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 3971513334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
New York University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179518NYMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Aug 23, 2022 Accepting new patients
Maimonides Medical Center Past Accepting new patients
United Medical Surgical PC Surgical Critical Care Past Accepting new patients

Locations

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

Networks

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

Organizations & group practices 3

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 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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1285611178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST STE 209",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICASTRO",
        "first_name": "JEFFREY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "179518",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CT",
            "license": "36193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01867858",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.