Mary Catherine Petriccione, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F380212-1 Issued in NY

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 639-2153

Fax

(212) 639-7107

NPI assigned

Sep 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Pediatric GroupGroup PAC ID 1557250958, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mpetriccione41109@mskcc.direct-ci.com

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.

• Memorial Pediatric Group

  • Pediatrics Physician
  • New York, NY
  • NPI 1750352381
  Medicare reassignment Care Compare group
• Mskcc Surgery Group

  • Surgical Oncology Physician
  • New York, NY
  • NPI 1699766261
  Medicare reassignment NPD

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1396931770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 STURBRIDGE PL",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105836019",
            "telephone_number": "212-639-2153",
            "fax_number": "212-717-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2153",
            "fax_number": "212-639-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICCIONE",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380212-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Petrelis, PA-C
• Rena Petrella, M.D.
• Claudia Petrello
• Massimo Oronzo Petrera, MD, FRCSC
• Joana Petrescu, MD, PHD
• Petros Dimitrios Petridis, MD
• Samuel Russel Petrie, MD
• Emily Petriello, PT, DPT
• Christine Petrik, LCSW
• Alice Petrikovsky

• Pediatric Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.