Active NPI
John David Capobianco, D.O.
- Family Medicine Physician
- Glen Cove, NY
National Provider Identifier
1245267970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 182685-1
- Practice address
- 20 Landing Rd
Glen Cove, NY 11542-2414 - Phone
- (516) 676-5005
- NPI assigned
- Jun 27, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 182685-1 | NY | |
| Family Medicine Physician | 207Q00000X | 182685-1 | NY | Primary |
| General Practice Physician | 208D00000X | 182685-1 | NY |
Addresses
Primary practice location
20 Landing Rd
Glen Cove, NY 11542-2414
Mailing address
21 Club Rd
Sea Cliff, NY 11579-2121
Phone (516) 676-5005
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041130000176 | NY | Practitioner - Osteopathic Manipulative Medicine | 8426013681 | Practice locations: Glen Head, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 182685-1 | NY | MD | Neuromusculoskeletal Medicine & OMM Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1245267970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 CLUB RD",
"city": "SEA CLIFF",
"state": "NY",
"postal_code": "115792121",
"telephone_number": "516-676-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 LANDING RD",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115422414",
"telephone_number": "516-676-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPOBIANCO",
"first_name": "JOHN",
"middle_name": "DAVID",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "NY",
"license": "182685-1",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "182685-1",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "182685-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glen Cove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.