Individual provider Active NPI

Anthony M Cuomo, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Carmel, NY
National Provider Identifier
1720012578
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
30972 Issued in NY
Practice address
667 Stoneleigh Ave
Suite 301
Carmel, NY 10512-2454
Phone
(845) 278-2101
Fax
(845) 278-8806
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 5112 CT
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30972 NY Primary

Addresses

Primary practice location

667 Stoneleigh Ave
Suite 301
Carmel, NY 10512-2454

Mailing address

667 Stoneleigh Ave
Suite 301
Carmel, NY 10512-2454
Phone (845) 278-2101

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
I20070425000657 NY Practitioner - Oral Surgery 2264538966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30972NYMDOral and Maxillofacial Surgery (Dentist)

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720012578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE",
            "address_2": "SUITE 301",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122454",
            "telephone_number": "845-278-2101",
            "fax_number": "845-278-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE",
            "address_2": "SUITE 301",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122454",
            "telephone_number": "845-278-2101",
            "fax_number": "845-278-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUOMO",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "5112",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "30972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.