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MR. DAMIEN ANTHONY DECOLLIBUS PA
NPI 1114009115
Physician Assistant - Surgical in New York, NY

Active since October 19, 2006PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
100 E 77TH ST, DIVISION OF VASCULAR SURGERY, NEW YORK, NY 10075(212) 434-4264(212) 434-4231 Get Directions Write a Review

NPPES record last updated: September 10, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Damien Anthony Decollibus Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DAMIEN ANTHONY DECOLLIBUS PA (NPI 1114009115) is an individual surgical provider in New York, New York, licensed in New York (010067) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Lenox Hill Hospital, and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2004).

NPPES Registry Identity

NPI1114009115
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. DAMIEN ANTHONY DECOLLIBUSCredential: PA
Location Address100 E 77TH ST, DIVISION OF VASCULAR SURGERYNew York, NY 10075-1850
Mailing Address100 E 77th St, Division Of Vascular SurgeryNew York, NY 10075-1850 · (212) 434-4264 · Fax (212) 434-4231
Phone(212) 434-4264
Fax(212) 434-4231
Sole ProprietorNo
Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2004
Enumeration DateOctober 19, 2006
Last NPPES UpdateSeptember 10, 2008
✔ NPI 1114009115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NY · 010067
100 E 77TH ST, New York, NY 10075
Open in Google Maps ↗

Other Identifiers 2

Medicaid00246075NY
Medicare ID-Type Unspecified00330231NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Damien Anthony Decollibus Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860675790
PECOS Enrollment IDI20110330000333
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
49 services41 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
37 services22 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lenox Hill Hospital

Acute Care Hospitals · New York, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330119
Location100 East 77th StreetNew York, NY 10021 · New York County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CATHERINE WILLIAMS HALL NURSE PRACTITIONER
Nurse Practitioner (Neonatal, Critical Care)
100 E 77TH ST
NEW YORK, NY 10075
New York County (212) 434-2000
MS. PUNAM SHERPA PA
Physician Assistant
100 E 77TH ST
NEW YORK, NY 10075
New York County (646) 752-1480
MARIA PUTILINA
Student in an Organized Health Care Education/Training Program
100 E 77TH ST
NEW YORK, NY 10075
New York County (212) 434-2150
LINDA MANGERA
Student in an Organized Health Care Education/Training Program
100 E 77TH ST
NEW YORK, NY 10075
New York County (212) 434-2000
JUSTIN WAN
Student in an Organized Health Care Education/Training Program
100 E 77TH ST
NEW YORK, NY 10075
New York County (212) 434-4763
AMANDA JEAN BATTISTA PA
Physician Assistant
100 E 77TH ST
NEW YORK, NY 10075
New York County (212) 434-2000
SAGAR MULAY
Anesthesiology
100 E 77TH ST
NEW YORK, NY 10075
New York County (731) 676-2644
REBECCA SAUNDERS AGACNP
Nurse Practitioner (Acute Care)
100 E 77TH ST
NEW YORK, NY 10075
New York County (212) 434-6500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Damien Decollibus's NPI number?

The NPI number for Damien Decollibus is 1114009115. It was assigned to this individual provider in the NPPES registry on October 19, 2006.

Where is Damien Decollibus located?

Damien Decollibus practices at 100 E 77th St Division Of Vascular Surgery, New York, NY 10075. The listed phone number is (212) 434-4264.

What is Damien Decollibus's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Damien Decollibus enrolled in Medicare?

Yes. Damien Decollibus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Damien Decollibus affiliated with any hospitals?

According to CMS data, Damien Decollibus is affiliated with Lenox Hill Hospital.

When was this NPI record last updated?

The NPPES record for Damien Decollibus was last updated on September 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.