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

Mark A Profetto, FNP

Individual provider Family Nurse Practitioner · NPI 1487852851

Mark A Profetto, FNP is a Nurse Practitioner in Fayetteville, New York. Qualified in 2007, 19 years ago. Practices with New York Anesthesiology Medical Specialties PC, a 29-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
19
Licensed in
NY
In the registry since
2007
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

4103 Medical Center Dr
Fayetteville, NY 13066-6600
Phone: (315) 637-7800
Fax: (315) 637-7808
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 33 335305 (NY)

Record details

NPI number1487852851
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedJuly 6, 2007
Last updated in NPPESDecember 2, 2011
Mailing address4103 Medical Center Dr, Fayetteville, NY 13066-6600

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice New York Anesthesiology Medical Specialties Pc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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