NPIMap

Individual provider Active NPI

John P Delisio, P.A.

  • Surgical Physician Assistant
  • Newark, NY
National Provider Identifier
1720180540
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
010933 Issued in NY
Practice address
1202 Driving Park Ave
Ste 5
Newark, NY 14513-1057
Phone
(315) 359-2690
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 010933 NY Primary

Addresses

Primary practice location

1202 Driving Park Ave
Ste 5
Newark, NY 14513-1057

Mailing address

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

Other identifiers 1

IdentifierTypeStateIssuer
03141320MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.delisio@rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070202000365 NY Practitioner - Physician Assistant 0749177574 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 462-5711

4 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 906-4059

Hospital & facility affiliations

  • Newark-Wayne Community Hospital Hospital, Newark, NY, CCN 330030
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
83.5
Promoting interoperability
62
Improvement activities
40
Cost
81.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010933NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Wayne Community Hospital CurrentSince Mar 16, 2015 Accepting new patients
Wyoming County Current Accepting new patients
Rochester General Hospital CurrentSince Oct 20, 2005 Accepting new patients
Western New York Medical Practice P.C CurrentSince Jun 1, 2013 Accepting new patients
Wyoming County Current Accepting new patients
Western New York Medical Practice P.C. CurrentSince Jun 1, 2013 Accepting new patients
Wyoming County CurrentSince Oct 4, 2023 Accepting new patients
Rochester General Hospital CurrentSince Oct 20, 2005 Accepting new patients

Locations

3719 Union Rd
Ste 218
Cheektowaga, NY 14225
Phone (716) 206-1503

1202 Driving Park Ave
Ste 5
Newark, NY 14513
Phone (315) 359-2661

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

400 N Main St
Warsaw, NY 14569
Phone (585) 786-1555

Interoperability endpoints

  • Direct secure messaging: jdelisio@cfu.medentdirect.com

Organizations & group practices 10

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 2

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1720180540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 DRIVING PARK AVE",
            "address_2": "STE 5",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131057",
            "telephone_number": "315-359-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISIO",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "010933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03141320",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.delisio@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1202 Driving Park Ave",
            "address_2": "Ste 5",
            "city": "Newark",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145131057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

Verify at the official NPI Registry.