Individual provider Active NPI

Michael Hamlen Campanella, M.D.

  • Obstetrics & Gynecology Physician
  • Staten Island, NY
National Provider Identifier
1477703130
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
250528 Issued in NY
Practice address
1855 Richmond Ave
Staten Island, NY 10314
Phone
(347) 745-2828
Fax
(718) 761-7226
NPI assigned
Sep 30, 2008
Last updated
Sep 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 250528 NY Primary

Addresses

Primary practice location

1855 Richmond Ave
Staten Island, NY 10314

Mailing address

1855 Richmond Ave
Staten Island, NY 10314
Phone (347) 745-2828

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
I20111029000014 NY Practitioner - Obstetrics/Gynecology 7315110863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

4360 Hylan Blvd
Staten Island, NY 10312-6533
Phone (718) 818-5000

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

464 77TH St
Brooklyn, NY 11209-3206
Phone (718) 680-8383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250528NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Sep 22, 2011 Accepting new patients
Amboy Medical Practice PC Obstetrics & Gynecology CurrentSince Sep 22, 2011 Accepting new patients
Richmond Medical Center Past Accepting new patients

Locations

2066 Richmond Ave
Ste 1R
Staten Island, NY 10314
Phone (646) 661-1338

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

4360 Hylan Blvd
Staten Island, NY 10312
Phone (718) 818-4360

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: michael.campanella.1@19656.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1477703130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "347-745-2828",
            "fax_number": "718-761-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "347-745-2828",
            "fax_number": "718-761-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANELLA",
        "first_name": "MICHAEL",
        "middle_name": "HAMLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "250528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.