Individual provider Active NPI

Salvatore Joseph Milazzo, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1619500063
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
024822 Issued in NY
Practice address
1 W 125TH St FRNT 3
New York, NY 10027-4524
Phone
(212) 265-2500
Fax
(646) 952-0260
NPI assigned
Feb 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1171311 NY
Physician Assistant 363A00000X 024822 NY Primary

Addresses

Primary practice location

1 W 125TH St FRNT 3
New York, NY 10027-4524

Mailing address

2 Oak Ave
Bronx, NY 10465-3822
Phone (646) 938-7336

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022001643 NY Practitioner - Physician Assistant 7012305162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology PCGroup PAC ID 3274526850, 67 clinicians

Practice addresses (Care Compare)

1 -3 W 125TH St
New York, NY 10027-4524
Phone (212) 246-6800

2432 Grand Concourse
RM 501
Bronx, NY 10458-5204
Phone (718) 537-5000

4 Technology Dr
Suite 180
East Setauket, NY 11733-4068
Phone (631) 689-3188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024822NYMDOccupational Therapist
1171311NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Buglino DO PLLC Past Accepting new patients
Advanced Dermatology of New York PC Past Accepting new patients
Howard D. Solomon, DO, PC Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: smilazzo@advderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1619500063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OAK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653822",
            "telephone_number": "646-938-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W 125TH ST FRNT 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274524",
            "telephone_number": "212-265-2500",
            "fax_number": "646-952-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAZZO",
        "first_name": "SALVATORE",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-13",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1171311",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.