Individual provider Active NPI

Armando Iannicello, M.D

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
National Provider Identifier
1720499387
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
294994 Issued in NY
Practice address
369 Lexington Ave RM 800
New York, NY 10017
Phone
(347) 252-6732
Fax
(347) 252-6731
NPI assigned
May 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 294994 NY Primary

Addresses

Primary practice location

369 Lexington Ave RM 800
New York, NY 10017

Mailing address

369 Lexington Ave RM 800
New York, NY 10017-6536
Phone (347) 252-6732

Other practice location 1

369 Lexington Ave Rm 800
New York, NY 10017
Phone (347) 252-6732

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190325002112 NY Practitioner - Physical Medicine and Rehabilitation 5193065316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unique Pain Medicine PLLCGroup PAC ID 4688858616, 4 clinicians

Practice addresses (Care Compare)

369 Lexington Ave
FL 19
New York, NY 10017-6522
Phone (929) 363-0303

626 Sheepshead Bay Rd
Suite 520
Brooklyn, NY 11224-3606
Phone (929) 363-0303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
294994NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Pain Medicine PLLC Physical Medicine & Rehabilitation CurrentSince Apr 1, 2019 Accepting new patients
Kotlyar Medical PC CurrentSince Oct 13, 2019 Accepting new patients

Locations

626 Sheepshead Bay Rd
Ste 520
Brooklyn, NY 11224
Phone (929) 363-0303

1599 E 15th St
Ste 2
Brooklyn, NY 11230
Phone (347) 252-6732

1204 Avenue U
Ste 1075
Brooklyn, NY 11229

369 Lexington Ave
Fl 19
New York, NY 10017
Phone (212) 779-2944

369 Lexington Ave
Rm 800
New York, NY 10017
Phone (347) 252-6732

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1720499387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 LEXINGTON AVE RM 800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176536",
            "telephone_number": "347-252-6732",
            "fax_number": "347-252-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 LEXINGTON AVE RM 800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "347-252-6732",
            "fax_number": "347-252-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "369 Lexington Ave Rm 800",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10017",
            "country_code": "US",
            "telephone_number": "347-252-6732",
            "fax_number": "347-252-6731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANNICELLO",
        "first_name": "ARMANDO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "294994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.