Individual provider Active NPI

Nicholas A Marchese, DPM

  • Foot & Ankle Surgery Podiatrist
  • Massapequa, NY
National Provider Identifier
1790794915
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N005755 Issued in NY
Practice address
838 N Broadway Unit B
Massapequa, NY 11758-2451
Phone
(516) 799-0550
Fax
(516) 799-0562
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N005755 NY Primary

Addresses

Primary practice location

838 N Broadway Unit B
Massapequa, NY 11758-2451

Mailing address

838 N Broadway Unit B
Massapequa, NY 11758-2451
Phone (516) 799-0550

Other identifiers 1

IdentifierTypeStateIssuer
02521566MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000617 NY Practitioner - Podiatry 1456343284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gervasio and Marchese LLPGroup PAC ID 8325219405, 2 clinicians

Practice addresses (Care Compare)

838 N Broadway
Unit B
Massapequa, NY 11758-2451
Phone (516) 799-0550

Merit-based Incentive Payment System (MIPS)

Final score
90.38 of 100Reported as individual
Quality
76.2
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue141
Removal of skin lesions1-10
Removal of nail tissue1200
Removal or shaving of skin growth600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005755NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gervasio & Marchese LLP Foot & Ankle Surgery CurrentSince Aug 15, 2011 Accepting new patients

Locations

838 N Broadway
Unit B
Massapequa, NY 11758
Phone (516) 799-0550

1000 Park Blvd
Ste 101
Massapequa Park, NY 11762
Phone (516) 799-0550

1000 Park Blvd
Massapequa Pk, NY 11762
Phone (516) 795-8446

Organizations & group practices 1

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1790794915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 N BROADWAY UNIT B",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582451",
            "telephone_number": "516-799-0550",
            "fax_number": "516-799-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 N BROADWAY UNIT B",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582451",
            "telephone_number": "516-799-0550",
            "fax_number": "516-799-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHESE",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-09-08",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N005755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02521566",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.