John Sparrow Duffy, MD
Individual provider Active NPI Family Medicine Physician · Canton, NY
NPI 1295710358 · NPPES record last updated Oct 21, 2022
Key facts
- NPI
- 1295710358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 284577 (NY)
- Practice address
- 39 West Main Street
Canton, NY 13617 - Phone
- (315) 379-4700
- Fax
- (315) 713-6512
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Claxton-Hepburn Medical Center
Carthage Area Hospital Inc
United Cerebral Palsy Association of the North Country Inc
Practice addresses (Care Compare)
100 Horwood PL
Ogdensburg, NY 13669-4510
Phone (315) 394-9462
1001 W St
Carthage, NY 13619-9703
Phone (315) 493-1000
117 N Mechanic St
Carthage, NY 13619-1252
Phone (315) 493-4187
214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600
2263 State Hwy 310
Madrid, NY 13660-3224
Phone (315) 322-8947
3 Bridge St
Carthage, NY 13619-1353
3 Bridge St
Carthage, NY 13619-1360
Phone (315) 493-0110
39 W Main St
Canton, NY 13617-1358
Phone (315) 379-4700
4 Commerce LN
Canton, NY 13617-3739
Phone (315) 386-8191
Hospital & facility affiliations
- Health Services of Northern New York Inc Chha
- Northern Lights Home Health Care
- Canton-Potsdam Hospital
- Carthage Area Hospital, Inc
- Carthage Area Hospital, Inc
- Gouverneur Hospital
- SLHS Massena, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160623001985 | NY | Practitioner - Family Practice | 2163317405 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 284577 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carthage Area Hospital, Inc. | Current |
Accepting new patients | |
| Carthage Area Hospital Inc | Current |
Accepting new patients | |
| Claxton-Hepburn Medical Center | Current |
Accepting new patients | |
| Carthage Area Hospital Inc | Current | Accepting new patients | |
| Advanced Integrated Medical | Family Medicine | Past | Accepting new patients |
| Graybar Chiropractic, Inc. | Past | Accepting new patients | |
| Carthage Area Hospital Inc. | Past | Accepting new patients | |
| North Raleigh Ophthalmology, P.a. | Past | Accepting new patients | |
| Mary Rutan Hospital | Family Medicine | Past | Accepting new patients |
Locations
39 W Main St
Canton, NY 13617
Phone (315) 379-4700
1001 West St
Carthage, NY 13619
Phone (315) 493-1000
214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660
Interoperability endpoints
- jduffy@cahclinics.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 284577 | NY | Yes |
Addresses
Primary practice location
39 West Main Street
Canton, NY 13617
Mailing address
39 West Main Street
Canton, NY 13617
Phone (315) 379-4700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04392256 | Medicaid | NY |
NPI Registry JSON
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1295710358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 WEST MAIN STREET",
"city": "CANTON",
"state": "NY",
"postal_code": "13617",
"telephone_number": "315-379-4700",
"fax_number": "315-713-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 WEST MAIN STREET",
"city": "CANTON",
"state": "NY",
"postal_code": "13617",
"telephone_number": "315-379-4700",
"fax_number": "315-713-6512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFFY",
"first_name": "JOHN",
"middle_name": "SPARROW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "284577",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04392256",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, NY
- Nereida Diaz
- Ashley E. Dimatteo
- O. Jeanne Dolly
- Kathleen W Doyle
- Dr. Gary L. Carr, DC, PLLC
- Natasha Duncan
- Amanda Earl
- Michele Lee Earle
- Richard Maurice Edwards Jr.
- Sara Elliott
All providers in Canton, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.