John Depetrillo Jr., M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

250815 Issued in NY

Practice address

10201 66TH Rd
Forest Hills, NY 11375-2029

Phone

(718) 830-4359

Fax

(718) 830-1015

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ, TX, SC, CA, MS, WA7 enrollments

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 7

Specialty

Internal MedicineAlso: Critical Care (Intensivists)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ccmma NJ LLCGroup PAC ID 8123392495, 31 clinicians

Critical Care Medical Management Associates PLLCGroup PAC ID 4880844521, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S General Hospital Hospital, Passaic, NJ, CCN 310006
• Saint Clare'S Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 43)

Interoperability endpoints

• Direct secure messaging: jdepetrillo1254907@direct.sw.org

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.

• Critical Care Medical Management Associates PLLC

  • Critical Care Medicine (Anesthesiology) Physician
  • Sleepy Hollow, NY
  • NPI 1194090878
  Medicare reassignment Care Compare group NPD
• Ccmma NJ LLC

  • Critical Care Medicine (Anesthesiology) Physician
  • Passaic, NJ
  • NPI 1124543095
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Internal Medicine

  Medicare reassignment NPD
• Ccmma Ca PC

  • Critical Care Medicine (Anesthesiology) Physician
  • Redding, CA
  • NPI 1679293443
  Medicare reassignment NPD
• Copiah County Medical Center

  • Critical Access Hospital
  • Hazlehurst, MS
  • NPI 1588667281
  Medicare reassignment NPD
• Greenwood Leflore Hospital

  • Hospitalist Physician
  • Greenwood, MS
  • NPI 1720048440
  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Ccmma TX PLLC

  • Anesthesiology Physician
  • New York, NY
  • NPI 1841829819

  TX

  Medicare reassignment
• Ccmma SC LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Sumter, SC
  • NPI 1245715796
  Medicare reassignment
• Copiah County Medical Center

  • Critical Access Hospital
  • Hazlehurst, MS
  • NPI 1083039663
  NPD
• Copiah County Medical Center

  • Rural Health Clinic/Center
  • Crystal Springs, MS
  • NPI 1972603819
  NPD
• Multicare Health System

  • Cardiovascular Disease Physician
  • Everett, WA
  • NPI 1164185765
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - Saint Clare'S LLC

  • General Acute Care Hospital
  • Denville, NJ
  • NPI 1598144362
  Care Compare affiliation
• Prime Healthcare Services - St. Mary'S Passaic LLC

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1770901761
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1013127562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 35TH ST",
            "address_2": "APT 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052206",
            "telephone_number": "516-509-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 66TH RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752029",
            "telephone_number": "718-830-4359",
            "fax_number": "718-830-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPETRILLO",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "250815-1",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "250815-1",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "250815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuella Denis
• Dawn Denny, LMSW
• Dental Made Easy P.C.
• Olena Denysova, FNP
• Angelina Anuradha Deonarine
• Jessica Khloe Cabilao Dequito, PT
• Almira Dervisevic, PHARMD
• Deepna Desai, OTR/L
• Girish Desai, MD
• Bertrand Marc Desir, MD

• Critical Care Medicine (Internal Medicine) Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Critical Care Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.