Individual provider Active NPI

John Byrne, M.D.

  • Allergy & Immunology Physician
  • Riverhead, NY
National Provider Identifier
1144227208
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
2113491 Issued in NY
Practice address
1149 Old Country Road
Suite E-1
Riverhead, NY 11901-2063
Phone
(631) 591-2209
Fax
(631) 591-2194
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 2113491 NY Primary

Addresses

Primary practice location

1149 Old Country Road
Suite E-1
Riverhead, NY 11901-2063

Mailing address

1149 Old Country Road
Suite E-1
Riverhead, NY 11901-2063
Phone (631) 591-2209

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
I20060718000279 NY Practitioner - Allergy/Immunology 7719990696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
New York Medical College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Village Allergy and Asthma, PLLCGroup PAC ID 2567699556, 2 clinicians

Practice addresses (Care Compare)

1149 Old Country Rd
Suite E1
Riverhead, NY 11901-2063
Phone (631) 591-2209

2 Medical Dr C
Port Jefferson Station, NY 11776-1598
Phone (631) 591-2209

3771 Nesconset Hwy
Suite 105
South Setauket, NY 11720
Phone (631) 675-6474

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2113491NYMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East End Allergy and Asthma Care, PC Allergy & Immunology CurrentSince Jan 30, 2008 Accepting new patients

Locations

2 Medical Dr
Ste C
Port Jefferson Station, NY 11776
Phone (631) 591-2209

235 Osborn Ave
Riverhead, NY 11901
Phone (631) 591-2209

1149 Old Country Rd
Ste E1
Riverhead, NY 11901
Phone (631) 591-2209

Interoperability endpoints

  • Direct secure messaging: john.byrne.1@20996.direct.athenahealth.com
  • Direct secure messaging: jbyrne64626@northwell.direct-ci.com

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 6

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1144227208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 OLD COUNTRY ROAD",
            "address_2": "SUITE E-1",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012063",
            "telephone_number": "631-591-2209",
            "fax_number": "631-591-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 OLD COUNTRY ROAD",
            "address_2": "SUITE E-1",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012063",
            "telephone_number": "631-591-2209",
            "fax_number": "631-591-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "2113491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.