Joseph M Carrucciu, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

158313 Issued in NY

Practice address

75 N Country Rd
Port Jefferson, NY 11777-2119

Phone

(631) 473-1320

Fax

(631) 473-1320

NPI assigned

Aug 12, 2006

Last updated

Aug 17, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John T. Mather Memorial Hospital

  • Psychiatry Physician
  • Port Jefferson Station, NY
  • NPI 1376642371
  Medicare reassignment NPD
• John T Mather Memorial Hospital

  • Obesity Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1366816894
  NPD
• John T Mather Memorial Hospital

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Port Jefferson, NY
  • NPI 1922486182
  NPD
• John T. Mather Memorial Hospital

  • Emergency Medicine Physician
  • Port Jefferson, NY
  • NPI 1104913748
  NPD
• John T. Mather Memorial Hospital

  • Neuromusculoskeletal Medicine & OMM Physician
  • Port Jefferson, NY
  • NPI 1285920231
  NPD
• John T. Mather Memorial Hospital

  • Diagnostic Radiology Physician
  • Port Jefferson, NY
  • NPI 1336428796
  NPD
• John T. Mather Memorial Hospital

  • Adult Health Nurse Practitioner
  • Port Jefferson, NY
  • NPI 1396834750
  NPD
• John T. Mather Memorial Hospital

  • Family Nurse Practitioner
  • Port Jefferson, NY
  • NPI 1417044066
  NPD
• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  NPD
• John T. Mather Memorial Hospital

  • Nurse Practitioner
  • Port Jefferson, NY
  • NPI 1821185109
  NPD
• John T. Mather Memorial Hospital

  dba Breast Center

  • Diagnostic Radiology Physician
  • Port Jefferson, NY
  • NPI 1891816070
  NPD
• John T. Mather Memorial Hospital

  • Hospitalist Physician
  • Port Jefferson, NY
  • NPI 1932296316
  NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1063424828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BELLE TERRE RD",
            "address_2": "SUITE 100",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772316",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-473-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUCCIU",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "158313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01018148",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucien John B Cardinal, MD
• Barbara Carlstrom
• Susanne Carmello, LMFT
• Hilsha Carrion, DMD
• Wesley Vanwye Carrion
• Anthony J Caruso, D.D.S.
• Melissa A Cascino
• Ruth Liliana Castillo de Guzman, RN
• Joyce Marie Catalano, OTRL
• Maureen Cataldo, NPP

• Diagnostic Radiology Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.