NPIMap

Individual provider Active NPI

Maria Vissicchio, MD

  • Diagnostic Radiology Physician
  • West Islip, NY
National Provider Identifier
1356318463
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
185368 Issued in NY
Practice address
1000 Montauk Highway
West Islip, NY 11795
Phone
(631) 376-4027
NPI assigned
Mar 7, 2006
Last updated
Mar 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 185368 NY Primary

Addresses

Primary practice location

1000 Montauk Highway
West Islip, NY 11795

Mailing address

52 Main St
Bedford Hills, NY 10507-1814
Phone (914) 666-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041214000765 NY Practitioner - Diagnostic Radiology 2668439332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York at Stony Brook, School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone (631) 628-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology CurrentSince Jan 1, 2021 Accepting new patients
St. Francis Cardiac Prevention Services PC Diagnostic Radiology CurrentSince Oct 17, 2018 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology CurrentSince Jan 1, 2021 Accepting new patients
CHS Physician Partners, P.C Past Accepting new patients
St Catherine of Siena Medical Center Past Accepting new patients
Radiology Consulting of Long Island PLLC Diagnostic Radiology Past Accepting new patients
Island Diagnostic Imaging Associates Past Accepting new patients

Locations

500 Commack Rd
Unit 150C
Commack, NY 11725
Phone (934) 223-7171

5 Cuba Hill Rd
Greenlawn, NY 11740
Phone (631) 628-5000

2200 Northern Blvd
Ste 118
Greenvale, NY 11548
Phone (516) 563-7910

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1356318463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MAIN ST",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105071814",
            "telephone_number": "914-666-2220",
            "fax_number": "914-666-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HIGHWAY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "11795",
            "telephone_number": "631-376-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSICCHIO",
        "first_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "185368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.