Individual provider Active NPI

Andrew Robert Campagnuolo, PA-C

  • Physician Assistant
  • Lindenhurst, NY
National Provider Identifier
1609789908
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
59 Fremont St
Lindenhurst, NY 11757-3806
Phone
(516) 450-1110
NPI assigned
Sep 26, 2026
Last updated
Sep 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

59 Fremont St
Lindenhurst, NY 11757-3806

Mailing address

59 Fremont St
Lindenhurst, NY 11757-3806
Phone (516) 450-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1609789908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 FREMONT ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117573806",
            "telephone_number": "516-450-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 FREMONT ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117573806",
            "telephone_number": "516-450-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPAGNUOLO",
        "first_name": "ANDREW",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-26",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.