Individual provider Active NPI

Ryan Mustacchio, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1316522915
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403678 Issued in NY
Practice address
274 Madison Ave RM 1501
New York, NY 10016-0701
Phone
(845) 709-2445
NPI assigned
Mar 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403678 NY Primary

Addresses

Primary practice location

274 Madison Ave RM 1501
New York, NY 10016-0701

Mailing address

274 Madison Ave RM 1501
New York, NY 10016-0701

Other practice location 1

101 True Blue Loop
Summerville, SC 29486-5415
Phone (845) 709-2445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231004004189 NY Practitioner - Nurse Practitioner 3173911872 Reassigns benefits to 1 organization
I20240215001333 SC Practitioner - Nurse Practitioner 3173911872

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rivia Medical PLLCGroup PAC ID 4880009943, 67 clinicians

Practice addresses (Care Compare)

350 E Ave
Suite 203
Rochester, NY 14604-2604
Phone (212) 203-1773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rivia Medical PLLC CurrentSince Apr 23, 2023 Accepting new patients

Locations

2125 Biscayne Blvd
Fl 3
Miami, FL 33137

274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773

Organizations & group practices 2

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1316522915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE RM 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE RM 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "845-709-2445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 True Blue Loop",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294865415",
            "country_code": "US",
            "telephone_number": "845-709-2445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTACCHIO",
        "first_name": "RYAN",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.