Individual provider Active NPI

Anthony Decicco

  • Physical Therapist
  • East Meadow, NY
National Provider Identifier
1801616065
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008495 Issued in NY
Practice address
801 Merrick Ave
East Meadow, NY 11554-4748
Phone
(516) 393-8900
NPI assigned
Oct 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008495 NY Primary

Addresses

Primary practice location

801 Merrick Ave
East Meadow, NY 11554-4748

Mailing address

972 Brush Hollow Rd FL 4
Westbury, NY 11590-1740
Phone (516) 474-2816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118002380 NY Practitioner - Physical Therapist in Private Practice 8527592203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008495NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Oct 1, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

801 Merrick Ave
East Meadow, NY 11554
Phone (516) 393-8900

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

972 Brush Hollow Rd
Fl 4
Westbury, NY 11590
Phone (516) 321-7526

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1801616065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD FL 4",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-474-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MERRICK AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544748",
            "telephone_number": "516-393-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECICCO",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "008495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.