Active NPI
Nicole M Passanante, PA
- Physician Assistant
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 013296
- Practice address
- 475 Seaview Ave
Staten Island, NY 10305-3436 - Phone
- (718) 226-9158
- Fax
- (718) 226-6964
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | P65540 | NY | |
| Physician Assistant | 363A00000X | 013296 | NY | Primary |
Addresses
Primary practice location
475 Seaview Ave
Staten Island, NY 10305-3436
Mailing address
1 Edgewater St
6TH Floor
Staten Island, NY 10305-4900
Phone (718) 226-4324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03196870 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
129 Sunrise Hwy W
Patchogue, NY 11772-1846
Phone (631) 230-5775
1930 Deer Park Ave
Deer Park, NY 11729-3328
Phone (631) 254-5900
2280 N Ocean Ave
Farmingville, NY 11738-2911
Phone (631) 698-7828
234 W Jericho Tpke
Huntington Station, NY 11746-3628
Phone (631) 423-5400
336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627
4724 Nesconset Hwy
Port Jefferson Station, NY 11776-2580
Phone (631) 474-5900
5600 Sunrise Hwy
Sayville, NY 11782-1017
Phone (631) 563-7828
600 Portion Rd
Ronkonkoma, NY 11779-1867
Phone (631) 471-5900
996 Middle Country Rd
Selden, NY 11784-2511
Phone (631) 736-5900
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.33 of 100
- Quality
- 82.1
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013296 | NY | MD | Physician Assistant |
| P65540 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City Medical of Upper East Side, PLLC | Current | Accepting new patients | |
| City Medical of Upper East Side, PLLC | Current | Accepting new patients |
Locations
3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345
336 E 86th St
New York, NY 10028
Phone (212) 772-3627
1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435
Interoperability endpoints
- nicole.passanante.1@2983.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Urgent Care Clinic/Center
- New York, NY
- NPI 1801277629
-
- Urgent Care Clinic/Center
- Bay Shore, NY
- NPI 1538625413
-
- Urgent Care Clinic/Center
- New York, NY
- NPI 1740913763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1952563843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EDGEWATER ST",
"address_2": "6TH FLOOR",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103054900",
"telephone_number": "718-226-4324",
"fax_number": "718-226-1039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053436",
"telephone_number": "718-226-9158",
"fax_number": "718-226-6964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSANANTE",
"first_name": "NICOLE",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "P65540",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "013296",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03196870",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.