Individual provider Active NPI

William A. Lorusso, RPA-C

  • Surgical Physician Assistant
  • Glen Cove, NY
National Provider Identifier
1407962590
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
000744-1 Issued in NY
Practice address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone
(516) 674-7591
Fax
(516) 674-1778
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 000744-1 NY Primary

Addresses

Primary practice location

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Mailing address

151 William St
Williston Park, NY 11596-1000
Phone (516) 747-6176

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060216000084 NY Practitioner - Physician Assistant 4183639826 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000744-1NYMDPsychoanalyst

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hosptial CurrentSince Dec 20, 2011 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
Central Suffolk Hospital CurrentSince Dec 20, 2011 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Plandome, NY 11030

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 5

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407962590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 WILLIAM ST",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115961000",
            "telephone_number": "516-747-6176",
            "fax_number": "516-877-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7591",
            "fax_number": "516-674-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORUSSO",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "000744-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.