Angelo John Procaccino, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

158773 Issued in NY

Practice address

310 East Shore Road
Suite 203
Great Neck, NY 11023

Phone

(516) 482-8657

Fax

(516) 829-0002

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• North Shore Long Island Jewish Healthcare

  • Cardiovascular Disease Physician
  • Westbury, NY
  • NPI 1215019500
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• North Shore Long Island Jewish Health Care Inc

  • Internal Medicine Physician
  • New York, NY
  • NPI 1912338385
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861587461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 EAST SHORE ROAD",
            "address_2": "SUITE 203",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11023",
            "telephone_number": "516-482-8657",
            "fax_number": "516-829-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 EAST SHORE ROAD",
            "address_2": "SUITE 203",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11023",
            "telephone_number": "516-482-8657",
            "fax_number": "516-829-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCACCINO",
        "first_name": "ANGELO",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "158773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenore Geralyn Primiano, RN
• Robert Prince, PH.D.
• Prince'S Employment Agency
• Prine Health Medical Group, PLLC
• Kristin L Prine
• John A Procaccino Jr., MD
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy PC
• Simona Vasilica Proteasa, MD
• Chelsea Provenzano, OTR/L

• Surgery Physician in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.