Active NPI
Chris Paul Petrosino, FNP-BC, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Cedarhurst, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F404363
- Practice address
- 74 Carman Ave
Cedarhurst, NY 11516-1905 - Phone
- (516) 295-7230
- Fax
- (516) 295-7232
- NPI assigned
- Mar 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F404363 | NY | Primary |
| Family Medicine Physician | 207Q00000X | 345002 | NY |
Addresses
Primary practice location
74 Carman Ave
Cedarhurst, NY 11516-1905
Mailing address
21 Ryder Ave
Dix Hills, NY 11746-6108
Phone (631) 404-8217
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | gzg9001@direct.nyp.org | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200417000621 | NY | Practitioner - Nurse Practitioner | 5294165148 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kings Physician Services PC
Practice addresses (Care Compare)
506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3000
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.47 of 100
- Quality
- 84.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.47
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F404363 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheryl a Pearl MD PC | Family Medicine | Current | Accepting new patients |
| Kings Physician Services, PC | Current | Accepting new patients | |
| Kings Physician Services, PC | Current | Accepting new patients |
Locations
506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279
506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677
2914 Lincoln Ave
Oceanside, NY 11572
Phone (516) 317-1681
11 Franklin Pl
Woodmere, NY 11598
Phone (516) 341-0151
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1326698879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1699301689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 RYDER AVE",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117466108",
"telephone_number": "631-404-8217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 CARMAN AVE",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115161905",
"telephone_number": "516-295-7230",
"fax_number": "516-295-7232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROSINO",
"first_name": "CHRIS",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "FNP-BC, PMHNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-21",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F404363",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "345002",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gzg9001@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cedarhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.