Individual provider Active NPI

Mark J Mancuso, MD

  • Anesthesiology Physician
  • Rochester, NY
National Provider Identifier
1467441899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
190093 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4122
Phone
(585) 255-8966
NPI assigned
Oct 18, 2005
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
Anesthesiology Physician 207L00000X 190093 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4122

Mailing address

PO Box 2005
East Syracuse, NY 13057-4505
Phone (315) 449-0513

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
I20071009000632 NY Practitioner - Anesthesiology 5193626638 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York at Buffalo School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geneva General Hospital, IncGroup PAC ID 7810809407, 88 clinicians
U of R Anesthesiology GroupGroup PAC ID 3476451105, 340 clinicians

Practice addresses (Care Compare)

196 N St
Geneva, NY 14456-1651
Phone (315) 787-5355

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-2141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190093NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Rochester, P.C. Anesthesiology CurrentSince Jul 22, 2023 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Geneva General Hospital Inc Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Geneva General Hospital, Inc CurrentSince May 1, 2023 Accepting new patients
U of R Anesthesiology Group Anesthesiology CurrentSince Aug 1, 2023 Accepting new patients

Locations

196 North St
Geneva, NY 14456
Phone (315) 787-4156

111 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2022

980 Westfall Rd
Ste 300
Rochester, NY 14618
Phone (585) 271-4480

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

601 Elmwood Ave
#604
Rochester, NY 14642
Phone (585) 275-2141

130 Allens Creek Rd
Ste 200
Rochester, NY 14618
Phone (585) 410-6545

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.

Hospital & facility affiliations 2

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467441899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574505",
            "telephone_number": "315-449-0513",
            "fax_number": "315-445-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-255-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "190093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.