Active NPI
John Bilello, RPH
- Pharmacist
- Kingston, NY
National Provider Identifier
1164690624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 35746
- Practice address
- 615 Broadway
Kingston, NY 12401-3603 - Phone
- (845) 338-0197
- NPI assigned
- Feb 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 35746 | NY | Primary |
Addresses
Primary practice location
615 Broadway
Kingston, NY 12401-3603
Mailing address
2124 Creek Hill Rd
Lancaster, PA 17601-5704
Phone (718) 288-9555
Other practice location 1
64 Route 109
West Babylon, NY 11704-6208
Phone (631) 587-3150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01315860 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35746 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buonadonna's Shoprite LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Buonadonna Shoprite LLC
- Community/Retail Pharmacy
- West Babylon, NY
- NPI 1598870370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1164690624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2124 CREEK HILL RD",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176015704",
"telephone_number": "718-288-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 BROADWAY",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124013603",
"telephone_number": "845-338-0197"
}
],
"practiceLocations": [
{
"address_1": "64 Route 109",
"address_purpose": "LOCATION",
"city": "West Babylon",
"state": "NY",
"postal_code": "117046208",
"country_code": "US",
"telephone_number": "631-587-3150",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BILELLO",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-18",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "35746",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01315860",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.