Individual provider Active NPI

Peter Joseph Miceli, M.D.

  • Otolaryngology Physician
  • Staten Island, NY
National Provider Identifier
1487701777
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
177014 Issued in NY
Practice address
1 Teleport Dr Ste 200
Staten Island, NY 10311-1000
Phone
(917) 830-0941
Fax
(718) 370-6733
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 177014 NY Primary

Addresses

Primary practice location

1 Teleport Dr Ste 200
Staten Island, NY 10311-1000

Mailing address

660 White Plains Rd FL 4
Tarrytown, NY 10591-5139
Phone (914) 984-2546

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
I20040713001065 NY Practitioner - Otolaryngology 7416935614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
New York Medical College, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

1 Teleport Dr
Suite 200
Staten Island, NY 10311-1000
Phone (718) 370-0072

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
89.91
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177014NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates LLP Otolaryngology CurrentSince May 17, 2017 Accepting new patients
ENT and Allergy Associates of Pennsylvania PLLC Otolaryngology Past Accepting new patients
Richmond Otolaryngology Group PC Otolaryngology Past Accepting new patients

Locations

1 Teleport Dr
Ste 200
Staten Island, NY 10311
Phone (718) 370-0072

660 White Plains Rd
Fl 4
Tarrytown, NY 10591
Phone (914) 984-2546

1086 N Broadway
Ste 220
Yonkers, NY 10701
Phone (914) 279-9500

Networks

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

Interoperability endpoints

  • Direct secure messaging: peter.miceli@direct.entandallergy.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1487701777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-984-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TELEPORT DR STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103111000",
            "telephone_number": "917-830-0941",
            "fax_number": "718-370-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "177014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.