Individual provider Active NPI

Nancy Anastasia Asseraf, DO

  • Family Medicine Physician
  • Staten Island, NY
National Provider Identifier
1770141277
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
316804 Issued in NY
Practice address
165 Vanderbilt Ave
Staten Island, NY 10304-2521
Phone
(718) 616-0999
Fax
(718) 616-0933
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 316804 NY Primary

Addresses

Primary practice location

165 Vanderbilt Ave
Staten Island, NY 10304-2521

Mailing address

165 Vanderbilt Ave
Staten Island, NY 10304-2521
Phone (718) 616-0999

Other names 1

  • Nancy Anastasia Bobrysh Former name

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
I20230906002572 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5496187726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

165 Vanderbilt Ave
Staten Island, NY 10304-2521
Phone (718) 616-0999

National Provider Directory

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

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince May 27, 2023 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince May 27, 2023 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

100 N Portland Ave
Brooklyn, NY 11205
Phone (718) 260-7500

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

165 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 616-0999

Networks

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

Interoperability endpoints

  • Direct secure messaging: nasseraf3686992@nychhc.direct-ci.com

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1770141277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 VANDERBILT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042521",
            "telephone_number": "718-616-0999",
            "fax_number": "718-616-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 VANDERBILT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042521",
            "telephone_number": "718-616-0999",
            "fax_number": "718-616-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSERAF",
        "first_name": "NANCY",
        "middle_name": "ANASTASIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "316804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "BOBRYSH",
            "middle_name": "ANASTASIA",
            "credential": "D.O",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.