Individual provider Active NPI

Theodore Macario

  • Medical Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1255702569
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
7901 Broadway
Elmhurst, NY 11373-1329
Phone
(718) 334-3050
Fax
(718) 334-3015
NPI assigned
Oct 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

7901 Broadway
Elmhurst, NY 11373-1329

Mailing address

370 W 2ND St
West Islip, NY 11795-2429

Other names 1

  • Mr. Theodore Macario Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831001883 NY Practitioner - Physician Assistant 6204109937 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
019350NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2017 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 21, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 21, 2020 Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

300 Community Dr
Manhasset, NY 11030

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1255702569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 W 2ND ST",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3050",
            "fax_number": "718-334-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACARIO",
        "first_name": "THEODORE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THEODORE",
            "last_name": "MACARIO",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.