Joseph T Miccoli, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

013446 Issued in NY

Practice address

215 Rockaway Tpke
Lawrence, NY 11559-1216

Phone

(516) 374-5024

Fax

(516) 374-5816

NPI assigned

Aug 11, 2009

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 FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Express Docs, LLC

  • Urgent Care Clinic/Center
  • Delray Beach, FL
  • NPI 1518309434
  Medicare reassignment NPD
• Expressdocs2Llc

  • Urgent Care Clinic/Center
  • Delray Beach, FL
  • NPI 1285497743
  NPD (past)

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1598997488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 ROCKAWAY TPKE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591216",
            "telephone_number": "516-374-5024",
            "fax_number": "516-374-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 ROCKAWAY TPKE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591216",
            "telephone_number": "516-374-5024",
            "fax_number": "516-374-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCOLI",
        "first_name": "JOSEPH",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-11",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merlyn Mathew, D.O.
• Tom Mathew, P.T.
• Nicole Mayer
• Jose L. Melendez, C.A.S.A.C.
• Raul Mendoza, M.D.
• Michael Bernstein MDPC
• Avital Miller, AGNP
• Biana Miller, PA
• Howard Saul Miller, DPM
• Sarah Miller, RDN

• Medical Physician Assistant in Lawrence, NY
• Providers in Lawrence, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.