Individual provider Active NPI

Anthony James Nunziato, PA-C

  • Physician Assistant
  • East Patchogue, NY
National Provider Identifier
1417469651
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021582 Issued in NY
Practice address
285 Sills Rd BLDG 18
East Patchogue, NY 11772-4808
Phone
(631) 475-1224
Fax
(631) 475-1588
NPI assigned
Oct 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021582 NY Primary

Addresses

Primary practice location

285 Sills Rd BLDG 18
East Patchogue, NY 11772-4808

Mailing address

285 Sills Rd BLDG 18
East Patchogue, NY 11772-4808
Phone (631) 475-1224

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
I20180115000329 NY Practitioner - Physician Assistant 9537428883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

301 E Main St
Bay Shore, NY 11706-8408

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

46 Brentwood Rd
Bay Shore, NY 11706-6924
Phone (631) 587-1800

Hospital & facility affiliations

  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

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
021582NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Nov 22, 2021 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince Aug 1, 2019 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince Aug 1, 2019 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

46 Brentwood Rd
Bay Shore, NY 11706
Phone (631) 206-1384

285 Sills Rd
Bldg 18
East Patchogue, NY 11772
Phone (631) 475-1241

285 Sills Rd
Bldg 5-6E
East Patchogue, NY 11772
Phone (631) 475-2858

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: anthonynunziato@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1417469651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 18",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724808",
            "telephone_number": "631-475-1224",
            "fax_number": "631-475-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 18",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724808",
            "telephone_number": "631-475-1224",
            "fax_number": "631-475-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNZIATO",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-27",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.