Individual provider Active NPI

Anthony Salvatore Raguso, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1790544484
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353636 Issued in NY
Practice address
162 Cranford Ave
Staten Island, NY 10306-2001
Phone
(347) 861-4328
NPI assigned
Mar 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 353636 NY Primary

Addresses

Primary practice location

162 Cranford Ave
Staten Island, NY 10306-2001

Mailing address

162 Cranford Ave
Staten Island, NY 10306-2001
Phone (347) 861-4328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
353636NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1790544484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 CRANFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062001",
            "telephone_number": "347-861-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 CRANFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062001",
            "telephone_number": "347-861-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGUSO",
        "first_name": "ANTHONY",
        "middle_name": "SALVATORE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.