Individual provider Active NPI

Paul Ricca, D.O.

  • Internal Medicine Physician
  • Massapequa, NY
National Provider Identifier
1609937705
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
199218 Issued in NY
Practice address
510 Hicksville Rd
Massapequa, NY 11758-1203
Phone
(516) 795-2626
Fax
(516) 799-7451
NPI assigned
Dec 12, 2006
Last updated
Aug 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 199218 NY Primary

Addresses

Primary practice location

510 Hicksville Rd
Massapequa, NY 11758-1203

Mailing address

510 Hicksville Rd
Massapequa, NY 11758-1203
Phone (516) 795-2626

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
I20040616000485 NY Practitioner - Internal Medicine 3375527468 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
199218NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Jan 1, 2013 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, PC Internal Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Long Island Primary Medical Care Internal Medicine Past Accepting new patients

Locations

510 Hicksville Rd
Massapequa, NY 11758
Phone (516) 729-2626

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

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

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

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1609937705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HICKSVILLE RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581203",
            "telephone_number": "516-795-2626",
            "fax_number": "516-799-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HICKSVILLE RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581203",
            "telephone_number": "516-795-2626",
            "fax_number": "516-799-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCA",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "199218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.