Individual provider Active NPI

Matthew Dicicco

  • Certified Registered Nurse Anesthetist
  • Oceanside, NY
National Provider Identifier
1558981233
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
678303 Issued in NY
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3000
NPI assigned
Apr 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 678303 NY Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

28 Fern St
Floral Park, NY 11001-3208
Phone (516) 233-6949

Other practice location 1

101 Nicholls Rd
Stony Brook, NY 11794-0001
Phone (631) 689-8333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200918001215 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385062686 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
678303NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC CurrentSince May 17, 2023 Accepting new patients
Office Based Anesthesia LLC CurrentSince Mar 14, 2025 Accepting new patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Sep 15, 2021 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Jul 7, 2020 Accepting new patients
Suffolk Anesthesiology Associates, PC CurrentSince Mar 6, 2025 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. CurrentSince Jun 1, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
New York University Current Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Singular Anesthesia Services, PLLC Past Accepting new patients

Locations

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

975 Stewart Ave
Garden City, NY 11530
Phone (516) 222-8600

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

27005 76th Ave
North New Hyde Pk, NY 11040

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

Interoperability endpoints

  • Direct secure messaging: matthew.dicicco@direct.stonybrookmedicine.edu

Organizations & group practices 12

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 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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1558981233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 FERN ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013208",
            "telephone_number": "516-233-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Nicholls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-689-8333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICICCO",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "678303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.