Individual provider Active NPI

Paul A Dicono, PA-C

  • Surgical Physician Assistant
  • Bay Shore, NY
National Provider Identifier
1942592464
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
014222 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(631) 968-3222
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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 014222 NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

26 Arrowood LN
Melville, NY 11747-1545
Phone (631) 470-4419

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
I20111207000339 NY Practitioner - Physician Assistant 7214102078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Critical Care LLPGroup PAC ID 9234239823, 29 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (516) 625-1014

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (516) 625-1014

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 625-1014

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 625-1014

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 625-1014

Hospital & facility affiliations

  • Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
  • Plainview Hospital Hospital, Plainview, NY, CCN 330331
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014222NYMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: pdicono69665@northwell.direct-ci.com

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 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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1942592464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 ARROWOOD LN",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117471545",
            "telephone_number": "631-470-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICONO",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "014222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.