MARY KATHRYN GIANNICO PA
NPI 1154908390
Physician Assistant in Port Jefferson, NY
About Mary Kathryn Giannico Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY KATHRYN GIANNICO PA (NPI 1154908390) is an individual physician assistant in Port Jefferson, New York, licensed in New York (026500) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
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
Mary Kathryn Giannico 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
John T Mather Memorial Hospital Of Port Jefferson
Acute Care Hospitals · Port Jefferson, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11777 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
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 Mary Giannico's NPI number?
The NPI number for Mary Giannico is 1154908390. It was assigned to this individual provider in the NPPES registry on March 25, 2021.
Where is Mary Giannico located?
Mary Giannico practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.
What is Mary Giannico's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Mary Giannico enrolled in Medicare?
Yes. Mary Giannico 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 Mary Giannico affiliated with any hospitals?
According to CMS data, Mary Giannico is affiliated with John T Mather Memorial Hospital Of Port Jefferson.
When was this NPI record last updated?
The NPPES record for Mary Giannico was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Mary Kathryn Giannico, PA · NPI 1154908390
Physician Assistant physician in Port Jefferson, New York. Individual provider, active in the CMS NPPES registry since March 25, 2021.
## Identity
- **NPI:** 1154908390 (Entity type: Individual)
- **Enumerated:** March 25, 2021
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 026500 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 75 N COUNTRY RD, Port Jefferson, NY 11777-2119
- **Phone:** (631) 473-1320
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** July 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1154908390) · Data from the CMS NPPES public registry.