Individual provider Active NPI

John David Capobianco, D.O.

  • Family Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1245267970
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
182685-1 Issued in NY
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

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130000176 NY Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 8426013681 Practice locations: Glen Head, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182685-1NYMDNeuromusculoskeletal 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

Verify at the official NPI Registry.