Individual provider Active NPI

Anthony Kyrollos, PA

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1760287601
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
41 Lott LN
Staten Island, NY 10314-7845
Phone
(347) 860-0101
NPI assigned
Feb 14, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

41 Lott LN
Staten Island, NY 10314-7845

Mailing address

41 Lott LN
Staten Island, NY 10314-7845
Phone (347) 860-0101

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417002529 NY Practitioner - Physician Assistant 9739604117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1010 N Broadway
Yonkers, NY 10701-1330
Phone (212) 731-6761

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 636-3666

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 28, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 28, 2025 Accepting new patients

Locations

13620 38th Ave
Ste 5F
Flushing, NY 11354
Phone (347) 909-7041

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

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": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1760287601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 LOTT LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147845",
            "telephone_number": "347-860-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 LOTT LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147845",
            "telephone_number": "347-860-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYROLLOS",
        "first_name": "ANTHONY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.