Individual provider Active NPI

John Daniel Giannone, M.D.

  • Psychiatry Physician
  • Southborough, MA
National Provider Identifier
1194950337
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
261076 Issued in MA
Practice address
24 Newton St
Southborough, MA 01772-1215
Phone
(508) 460-3190
Fax
(508) 460-3279
NPI assigned
May 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 261076 MA Primary

Addresses

Primary practice location

24 Newton St
Southborough, MA 01772-1215

Mailing address

630 Plantation St
Worcester, MA 01605-2038
Phone (508) 368-5532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150814012977 MA Practitioner - Psychiatry 8123261161 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055610NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Jan 12, 2016 Accepting new patients
Steward Medical Group, Inc CurrentSince Jan 12, 2016 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

77 Warren St
Brighton, MA 02135
Phone (617) 254-1271

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

77 Warren St
Fl 1
Brighton, MA 02135
Phone (617) 562-5200

Organizations & group practices 3

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": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1194950337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-368-5532",
            "fax_number": "508-460-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-460-3190",
            "fax_number": "508-460-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANNONE",
        "first_name": "JOHN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-18",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "261076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

Verify at the official NPI Registry.