Individual provider Active NPI

Mario F Alicandri, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1730140658
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
226120 Issued in NY
Practice address
65 Rose Ave
Staten Island, NY 10306-2246
Phone
(718) 979-9333
Fax
(718) 980-0408
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 226120 NY Primary

Addresses

Primary practice location

65 Rose Ave
Staten Island, NY 10306-2246

Mailing address

65 Rose Ave
Staten Island, NY 10306-2246
Phone (718) 979-9333

Other identifiers 1

IdentifierTypeStateIssuer
02599508MedicaidNY

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
I20041118000244 NY Practitioner - Internal Medicine 6800850900 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Aug 1, 2016 Accepting new patients
Physicians of University Hospital, PC Internal Medicine Current Accepting new patients
Physicians of University Hospital PC Internal Medicine CurrentSince Aug 1, 2016 Accepting new patients
Trifaro Physical Therapy,PC PastSince Jan 1, 1999 Accepting new patients

Locations

65 Rose Ave
Staten Island, NY 10306
Phone (718) 979-6344

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

511 Tysens Ln
Staten Island, NY 10306
Phone (718) 351-3870

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Organizations & group practices 4

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1730140658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ROSE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062246",
            "telephone_number": "718-979-9333",
            "fax_number": "718-980-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 ROSE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062246",
            "telephone_number": "718-979-9333",
            "fax_number": "718-980-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICANDRI",
        "first_name": "MARIO",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "226120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02599508",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.