Individual provider Active NPI

John Martinucci, M.D.

  • Anesthesiology Physician
  • Syosset, NY
National Provider Identifier
1023014826
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
187742 Issued in NY
Practice address
221 Jericho Tpke
Syosset, NY 11791-4515
Phone
(516) 496-6558
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 187742 NY Primary

Addresses

Primary practice location

221 Jericho Tpke
Syosset, NY 11791-4515

Mailing address

68 S Service Rd
Suite 350
Melville, NY 11747-2354
Phone (516) 945-3000

Other identifiers 1

IdentifierTypeStateIssuer
01450522MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000380 NY Practitioner - Anesthesiology 2961480488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Jan 1, 2023 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jan 1, 1994 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

27005 76th Ave
North New Hyde Pk, NY 11040

44 S Bayles Ave
Ste 206
Prt Washingtn, NY 11050
Phone (516) 562-0140

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1023014826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD",
            "address_2": "SUITE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472354",
            "telephone_number": "516-945-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 JERICHO TPKE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914515",
            "telephone_number": "516-496-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINUCCI",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "187742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01450522",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.