Individual provider Active NPI

Michaela Aileen Masciello, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Bay Shore, NY
National Provider Identifier
1639503410
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016893 Issued in NY
Practice address
280 E Main St
Bay Shore, NY 11706-8403
Phone
(631) 591-7400
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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 016893 NY Primary

Addresses

Primary practice location

280 E Main St
Bay Shore, NY 11706-8403

Mailing address

29 Dunlop CT
Commack, NY 11725-1774
Phone (516) 971-3315

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
I20150916001055 NY Practitioner - Physician Assistant 2163739665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 9234101221, 96 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 669-2255

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

301 E Main St
Bay Shore, NY 11706-8408

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

540 Union Blvd
West Islip, NY 11795-3105
Phone (631) 669-2255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016893NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital CurrentSince May 15, 2024 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 12, 2015 Accepting new patients
St. Francis Hospital CurrentSince May 15, 2024 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

280 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 666-3939

300 Community Dr
Plandome, NY 11030

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: mmasciello163183@direct-chsli.net
  • Direct secure messaging: michaelamasciello@nslijmedgr.allscriptsdirect.net

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 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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1639503410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 DUNLOP CT",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251774",
            "telephone_number": "516-971-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068403",
            "telephone_number": "631-591-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCIELLO",
        "first_name": "MICHAELA",
        "middle_name": "AILEEN",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.