Individual provider Active NPI

Michael Masciello

  • Registered Nurse
  • Garden City, NY
National Provider Identifier
1487329405
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
325430-01 Issued in NY
Practice address
711 Stewart Ave
Garden City, NY 11530-4731
Phone
(516) 227-3254
NPI assigned
Aug 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 325430-01 NY Primary

Addresses

Primary practice location

711 Stewart Ave
Garden City, NY 11530-4731

Mailing address

159 Harbor Rd
Cold Spring Harbor, NY 11724-1512
Phone (516) 456-3652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423000496 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799124863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sedation Vacation Perioperative Medicine PLLCGroup PAC ID 1759658594, 86 clinicians

Practice addresses (Care Compare)

1396 Myrtle Ave
Brooklyn, NY 11237-4513
Phone (718) 222-5999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
325430-01NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Centurion Midtown Anesthesia PLLC CurrentSince Feb 20, 2025 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Mar 5, 2024 Accepting new patients

Locations

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

11129 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-8900

8745 Lake Street Rd
Le Roy, NY 14482
Phone (585) 267-7570

305 E 47th St
New York, NY 10017
Phone (212) 203-8744

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

Organizations & group practices 2

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1487329405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 HARBOR RD",
            "city": "COLD SPRING HARBOR",
            "state": "NY",
            "postal_code": "117241512",
            "telephone_number": "516-456-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304731",
            "telephone_number": "516-227-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCIELLO",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "325430-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.