Individual provider Active NPI

Anthony M Pisacano, MD

  • Ophthalmology Physician
  • Bronx, NY
National Provider Identifier
1962483917
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
102139 Issued in NY
Practice address
2590 Frisby Ave
Bronx, NY 10461-3240
Phone
(718) 409-9400
Fax
(718) 409-9440
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 102139 NY Primary

Addresses

Primary practice location

2590 Frisby Ave
Bronx, NY 10461-3240

Mailing address

2590 Frisby Ave
Bronx, NY 10461-3240
Phone (718) 409-9400

Other identifiers 1

IdentifierTypeStateIssuer
0176018MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080320000524 NY Practitioner - Ophthalmology 5395747166 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a Pisacano MD PC Ophthalmology CurrentSince Aug 1, 2007 Accepting new patients

Locations

2590 Frisby Ave
Bronx, NY 10461
Phone (718) 239-1610

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.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1962483917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 FRISBY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613240",
            "telephone_number": "718-409-9400",
            "fax_number": "718-409-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 FRISBY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613240",
            "telephone_number": "718-409-9400",
            "fax_number": "718-409-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISACANO",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "102139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0176018",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.