Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Peter John Mancuso, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1558339200

Dr. Peter John Mancuso, DPM is a Podiatry in Brentwood, New York. Qualified in 1998, 28 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
28
Licensed in
NY
In the registry since
2006
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

620 Suffolk Ave
Brentwood, NY 11717-4306
Phone: (631) 231-1401
Fax: (631) 273-0125
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence N0056351 (NY)

Record details

NPI number1558339200
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedMarch 9, 2006
Last updated in NPPESApril 27, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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