Mark A Profetto, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

33 335305 Issued in NY

Practice address

4103 Medical Center Dr
Fayetteville, NY 13066-6600

Phone

(315) 637-7800

Fax

(315) 637-7808

NPI assigned

Jul 6, 2007

Last updated

Dec 2, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Anesthesiology Medical Specialties PCGroup PAC ID 3375535396, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.28 of 100Reported as group

Quality

95.25

Improvement activities

40

Cost

76.32

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mprofetto@hiemail.healtheconnections.org

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.

• New York Anesthesiology Medical Specialties PC

  dba New York Spine and Wellness Center

  • Interventional Pain Medicine Physician
  • North Syracuse, NY
  • NPI 1841285996
  Medicare reassignment Care Compare group NPD
• St. Joseph's Physician Health, P.C.

  • Anesthesiology Physician
  • Troy, NY
  • NPI 1154376770
  Medicare reassignment NPD
• New York Anesthesiology Medical Specialties, PC

  dba New York Spine and Wellness Center

  • Durable Medical Equipment & Medical Supplies
  • Camillus, NY
  • NPI 1023497203
  NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  NPD (past)

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1487852851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7800",
            "fax_number": "315-637-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7800",
            "fax_number": "315-637-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFETTO",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33  335305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Jason Power, D.C.
• Ellen E Powers, NP
• James Prezzano, M.D.
• Kelly Price, LMHC
• Steven A Procopio Jr., DDS
• Psychological Services for Self and Family, PLLC
• Ran D Anbar, Inc
• Susan M Randall-Mantella, RNNP
• Deanna Raymond Allen, P.A
• Cary Rector, M.S., LMHC

• Family Nurse Practitioner in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.