Individual provider Active NPI

Anthony Joshua Cerciello, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • New Hyde Park, NY
National Provider Identifier
1578083564
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
06188801 Issued in NY
Practice address
2001 Marcus Ave Ste N10
New Hyde Park, NY 11042-2048
Phone
(516) 775-1818
Fax
(516) 775-0892
NPI assigned
Jun 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 06188801 NY
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 06188801 NY Primary

Addresses

Primary practice location

2001 Marcus Ave Ste N10
New Hyde Park, NY 11042-2048

Mailing address

2001 Marcus Ave Ste N10
New Hyde Park, NY 11042-2048
Phone (516) 775-1818

Other practice location 1

474 Montauk Hwy
West Islip, NY 11795-4416
Phone (631) 376-1560

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
I20231106001407 NY Practitioner - Maxillofacial Surgery 3678977709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 Marcus Ave
Suite N10
New Hyde Park, NY 11042-2048
Phone (516) 775-1818

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06188801NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Professional Physician Services, P.C. CurrentSince Sep 16, 2023 Accepting new patients
New York Comprehensive Orthognathic and Maxillofacial Surgery PC Oral & Maxillofacial Surgery CurrentSince Feb 7, 2025 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Sep 16, 2023 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Sep 16, 2023 Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

2001 Marcus Ave
Ste N10
New Hyde Park, NY 11042
Phone (516) 775-1818

474 Montauk Hwy
West Islip, NY 11795
Phone (516) 775-1818

Organizations & group practices 4

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1578083564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE N10",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422048",
            "telephone_number": "516-775-1818",
            "fax_number": "516-775-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE N10",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422048",
            "telephone_number": "516-775-1818",
            "fax_number": "516-775-0892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "474 Montauk Hwy",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954416",
            "country_code": "US",
            "telephone_number": "631-376-1560",
            "fax_number": "631-376-1561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERCIELLO",
        "first_name": "ANTHONY",
        "middle_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "06188801",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "06188801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.