NPIMap

Individual provider Active NPI

Andrew James Ciancimino, M.D.

  • Internal Medicine Physician
  • Greenvale, NY
National Provider Identifier
1891062469
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
275566 Issued in NY
Practice address
101 Northern Blvd
Greenvale, NY 11548-1340
Phone
(516) 629-2090
Fax
(516) 629-2094
NPI assigned
Nov 25, 2011
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 275566 NY Primary

Addresses

Primary practice location

101 Northern Blvd
Greenvale, NY 11548-1340

Mailing address

PO Box 9500-6625
Philadelphia, PA 19195-6625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140829000763 NY Practitioner - Internal Medicine 9830317098 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 562-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Internal Medicine CurrentSince Aug 15, 2014 Accepting new patients
CHS Physician Partners, P.C CurrentSince Apr 15, 2020 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Mount Sinai School of Medicine Internal Medicine CurrentSince Aug 15, 2014 Accepting new patients
Cogent Medical Care PC Internal Medicine CurrentSince Nov 1, 2015 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
St. Francis Hospital Past Accepting new patients

Locations

101 Northern Blvd
Greenvale, NY 11548
Phone (516) 629-2090

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

1615 Northern Blvd
Manhasset, NY 11030
Phone (516) 627-3717

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

101 Hospital Rd
Rm 263
Patchogue, NY 11772
Phone (631) 687-4131

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: aciancimino68281@direct-chsli.net
  • FHIR API: https://api.platform.athenahealth.com/21626/brand/2/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1322179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1891062469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9500-6625",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191956625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NORTHERN BLVD",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481340",
            "telephone_number": "516-629-2090",
            "fax_number": "516-629-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIANCIMINO",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-25",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "275566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenvale, NY

Sources for this page

Verify at the official NPI Registry.