Individual provider Active NPI

John Bilello, RPH

  • Pharmacist
  • Kingston, NY
National Provider Identifier
1164690624
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
35746 Issued in NY
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

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01315860MedicaidNY

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

LicenseStateTypeSpecialty
35746NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.