Individual provider Active NPI

Mariano Siragusa

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1881275469
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310168 Issued in NY
Practice address
1200 South Ave Ste 301
Staten Island, NY 10314-3420
Phone
(718) 370-1400
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 310168 NY Primary

Addresses

Primary practice location

1200 South Ave Ste 301
Staten Island, NY 10314-3420

Mailing address

1200 South Ave
Staten Island, NY 10314-3413
Phone (718) 370-1400

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211106000075 NY Practitioner - Nurse Practitioner 7719376094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-5455

Hospital & facility affiliations

  • Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Sep 29, 2021 Accepting new patients
Weill Medical College of Cornell CurrentSince Feb 2, 2026 Accepting new patients
Weill Medical College of Cornell CurrentSince Feb 2, 2026 Accepting new patients
Amboy Medical Practice PC CurrentSince Sep 29, 2021 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Jul 31, 2023 Accepting new patients
Weill Cornell University Medical College Past Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

156 William St
New York, NY 10038
Phone (646) 962-4679

425 E 61st St
Fl 12
New York, NY 10065
Phone (646) 962-2399

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
Fl 9
New York, NY 10065
Phone (212) 746-5337

525 E 68th St
Ste F935
New York, NY 10065

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

1000 South Ave
Ste LL3
Staten Island, NY 10314
Phone (646) 605-8114

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

1200 South Ave
Staten Island, NY 10314
Phone (718) 370-1400

1200 South Ave
Ste 301
Staten Island, NY 10314
Phone (718) 370-1400

1161 Victory Blvd
Ste B
Staten Island, NY 10301

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: mariano.siragusa.1@19656.direct.athenahealth.com
  • Direct secure messaging: mariano.siragusa.1@24989.direct.athenahealth.com

Organizations & group practices 7

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1881275469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SOUTH AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143413",
            "telephone_number": "718-370-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SOUTH AVE STE 301",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143420",
            "telephone_number": "718-370-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAGUSA",
        "first_name": "MARIANO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2022-06-16",
        "certification_date": "2021-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.