NPIMap

Individual provider Active NPI

John Dominick McCarthy, D.O.

  • General Practice Physician
  • Staten Island, NY
National Provider Identifier
1235103342
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
211722 Issued in NY
Practice address
1776 Richmond Rd
Suite 5
Staten Island, NY 10306-2581
Phone
(718) 668-9300
Fax
(718) 668-1834
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 211722 NY Primary

Addresses

Primary practice location

1776 Richmond Rd
Suite 5
Staten Island, NY 10306-2581

Mailing address

3000 Hylan Blvd
Staten Island, NY 10306-4106
Phone (718) 668-9300

Other identifiers 1

IdentifierTypeStateIssuer
02060699MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510001051 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1951390434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3000 Hylan Blvd
Staten Island, NY 10306-4106
Phone (718) 668-9300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211722NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vytaliz Medical CurrentSince Jan 1, 2021 Accepting new patients
Richmond Total Medical, P.C. General Practice CurrentSince Jul 1, 2007 Accepting new patients
Silver Lake Specialized Rehabilitation & Care Center, LLC Past Accepting new patients
University Physicians Group P C General Practice Past Accepting new patients

Locations

3 E Evergreen Rd
Ste 1017
New City, NY 10956
Phone (201) 565-2533

1776 Richmond Rd
Ste 5
Staten Island, NY 10306
Phone (718) 668-9300

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

3000 Hylan Blvd
Staten Island, NY 10306
Phone (718) 668-9300

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1235103342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064106",
            "telephone_number": "718-668-9300",
            "fax_number": "718-668-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 RICHMOND RD",
            "address_2": "SUITE 5",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062581",
            "telephone_number": "718-668-9300",
            "fax_number": "718-668-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "JOHN",
        "middle_name": "DOMINICK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "211722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02060699",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.