Individual provider Active NPI

Alyssa Anne Criscuolo, PA-C

  • Surgical Physician Assistant
  • Englewood, NJ
National Provider Identifier
1831801414
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00746400 Issued in NJ
Practice address
350 Engle St RM 4503
Englewood, NJ 07631-1808
Phone
(201) 894-3893
Fax
(201) 894-3764
NPI assigned
Dec 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00746400 NJ Primary

Addresses

Primary practice location

350 Engle St RM 4503
Englewood, NJ 07631-1808

Mailing address

95 Mohawk TRL
Ringwood, NJ 07456-2950
Phone (973) 934-8187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230222001643 NJ Practitioner - Physician Assistant 8628441656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

350 Engle S
5TH FL Room 5518
Englewood, NJ 07631-1808
Phone (201) 568-5250

350 Engle St
Englewood, NJ 07631-1808

350 Engle St Main
Suite 256
Englewood, NJ 07631-1808
Phone (201) 894-3364

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00746400NJMDSurgical Physician Assistant

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1831801414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MOHAWK TRL",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074562950",
            "telephone_number": "973-934-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST RM 4503",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-894-3893",
            "fax_number": "201-894-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISCUOLO",
        "first_name": "ALYSSA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00746400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.