Individual provider Active NPI

Andrew J Restivo, M.D.

  • Emergency Medicine Physician
  • Long Is City, NY
National Provider Identifier
1376840850
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
260475 Issued in NY
Practice address
4751 40TH St
Long Is City, NY 11104-4052
Phone
(347) 724-7265
NPI assigned
Feb 18, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 260475 NY Primary

Addresses

Primary practice location

4751 40TH St
Long Is City, NY 11104-4052

Mailing address

4751 40TH St
Long Is City, NY 11104-4052
Phone (347) 724-7265

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
I20110519000073 NY Practitioner - Emergency Medicine 5092991448 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York Downstate Medical Center, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260475NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phelps Memorial Hospital Association CurrentSince May 1, 2011 Accepting new patients
Phelps Memorial Hospital Association Current Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2012 Accepting new patients
Montefiore Medical Center Emergency Medicine CurrentSince Jun 15, 2011 Accepting new patients
Montefiore Medical Center CurrentSince Jun 15, 2011 Accepting new patients
Phelps Memorial Hospital Association Emergency Medicine CurrentSince May 1, 2011 Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2012 Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: arestivo838027@nychhc.direct-ci.com

Organizations & group practices 9

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": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1376840850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 40TH ST",
            "city": "LONG IS CITY",
            "state": "NY",
            "postal_code": "111044052",
            "telephone_number": "347-724-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 40TH ST",
            "city": "LONG IS CITY",
            "state": "NY",
            "postal_code": "111044052",
            "telephone_number": "347-724-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTIVO",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "260475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Is City, NY

Sources for this page

Verify at the official NPI Registry.