Marc Anthony Disciullo, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

189612 Issued in NY

Practice address

489 Remsens LN
Muttontown, NY 11771-4501

Phone

(516) 624-0872

Fax

(516) 624-0873

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

53.46 of 100Reported as individual

Quality

45.25

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sedation Vacation Perioperative Medicine PLLC

  • Specialist
  • Valley Stream, NY
  • NPI 1891235404

  NY, Specialist

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1366471708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 REMSENS LN",
            "city": "MUTTONTOWN",
            "state": "NY",
            "postal_code": "117714501",
            "telephone_number": "516-624-0872",
            "fax_number": "516-624-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 REMSENS LN",
            "city": "MUTTONTOWN",
            "state": "NY",
            "postal_code": "117714501",
            "telephone_number": "516-624-0872",
            "fax_number": "516-624-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISCIULLO",
        "first_name": "MARC",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "189612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1443530",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Warren C Baine, DMD
• Marjorie Stein, M.D., PC
• Indira Bai Pammi, M.D.
• Deborah Platt, D.O.
• Dave Rosenbaum, PH. D

• Anesthesiology Physician in Muttontown, NY
• Providers in Muttontown, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.