Individual provider Active NPI

Russell Caprioli, DPM

  • Podiatrist
  • Valley Stream, NY
National Provider Identifier
1679507792
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003712 Issued in NY
Practice address
375 N Central Ave
Valley Stream, NY 11580
Phone
(516) 568-2319
Fax
(516) 568-2318
NPI assigned
Jul 11, 2006
Last updated
Sep 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N003712 NY Primary

Addresses

Primary practice location

375 N Central Ave
Valley Stream, NY 11580

Mailing address

375 N Central Ave
Valley Stream, NY 11580
Phone (516) 568-2319

Other identifiers 1

IdentifierTypeStateIssuer
00869769MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071008000178 NY Practitioner - Podiatry 3173618048 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Long Island Podiatry Group PCGroup PAC ID 9830080274, 4 clinicians
North Shore Lij Medical Group at North Nassau, PCGroup PAC ID 7618154550, 36 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

1991 Marcus Ave
Suite M103
New Hyde Park, NY 11042-2040
Phone (516) 327-0074

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

300 Community Dr
Manhasset, NY 11030-3816

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

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

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

375 N Central Ave
Valley Stream, NY 11580-1156
Phone (516) 825-4070

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

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
84.34
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue201
Removal of skin lesions74
Removal of nail tissue305
Removal or shaving of skin growth30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N003712NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
Long Island Podiatry Group, P.C. CurrentSince Nov 2, 1992 Accepting new patients
Long Island Podiatry Group, P.C. Podiatrist CurrentSince Mar 1, 1993 Accepting new patients
North Shore Lij Medical Group at North Nassau, PC CurrentSince Sep 22, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

70 Glen St
Ste 200
Glen Cove, NY 11542
Phone (516) 484-7893

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

1991 Marcus Ave
Ste M103
New Hyde Park, NY 11042
Phone (516) 327-0074

27005 76th Ave
North New Hyde Pk, NY 11040

375 N Central Ave
Valley Stream, NY 11580
Phone (516) 568-2319

Networks

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

Interoperability endpoints

  • Direct secure messaging: rcaprioli@lipodiatry.mdlogic.direct-ci.com
  • Direct secure messaging: russellcaprioli@nslijmedgr.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nassau University Medical CenterEast Meadow, NY, CCN 330027001 Hospital Corporate Director Sep 28, 2015
Nassau University Medical CtrEast Meadow, NY, CCN 33T027001 Hospital Corporate Director Sep 28, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1679507792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 N CENTRAL AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-568-2319",
            "fax_number": "516-568-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N CENTRAL AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-568-2319",
            "fax_number": "516-568-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPRIOLI",
        "first_name": "RUSSELL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00869769",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.