Individual provider Active NPI

Rosario Anthony Riccabene

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Bohemia, NY
National Provider Identifier
1659960573
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
003427 Issued in NY
Practice address
3480 Veterans Memorial Hwy
Bohemia, NY 11716-1068
Phone
(631) 289-0531
NPI assigned
Jan 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 003427 NY Primary

Addresses

Primary practice location

3480 Veterans Memorial Hwy
Bohemia, NY 11716-1068

Mailing address

7 Claire LN
Sayville, NY 11782-2420

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1659960573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CLAIRE LN",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 VETERANS MEMORIAL HWY",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161068",
            "telephone_number": "631-289-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCABENE",
        "first_name": "ROSARIO",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "003427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.