Individual provider Active NPI

Barry Douglas Jupiter, MD

  • Orthopaedic Surgery Physician
  • Hewlett, NY
National Provider Identifier
1295721405
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
131576 Issued in NY
Practice address
1512 Broadway
Hewlett, NY 11557-9998
Phone
(516) 374-6838
Fax
(516) 374-2362
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 131576 NY Primary

Addresses

Primary practice location

1512 Broadway
Hewlett, NY 11557-9998

Mailing address

PO Box 360
Hewlett, NY 11557-9998
Phone (516) 374-6838

Other identifiers 1

IdentifierTypeStateIssuer
00803558MedicaidNY

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
I20050310000744 NY Practitioner - Orthopedic Surgery 5193614147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
State University of New York Downstate Medical Center, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Musculoskeletal Care MD PCGroup PAC ID 9537058573, 14 clinicians

Practice addresses (Care Compare)

10825 Jamaica Ave
Richmond Hill, NY 11418-2243
Phone (718) 849-2321

125 Franklin Ave
203 Island Musculoskeletal Care MD PC
Hewlett, NY 11557-1429

2475 Eastchester Rd
Bronx, NY 10469-5915
Phone (718) 882-5314

485 N Ocean Ave
Patchogue, NY 11772-1762
Phone (631) 475-0353

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Island Musculoskeletal Care MD PC Orthopaedic Surgery CurrentSince Feb 24, 2018 Accepting new patients
Island Musculoskeletal Care MD PC Orthopaedic Surgery Current Accepting new patients
Island Musculoskeletal Care MD PC Orthopaedic Surgery CurrentSince Oct 13, 2008 Accepting new patients
Masoom H. Qadeer, M.D., P.C. Past Accepting new patients

Locations

2475 Eastchester Rd
Bronx, NY 10469
Phone (718) 547-8967

1993 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4031

1512 Broadway
Hewlett, NY 11557
Phone (516) 374-6838

485 New North Ocean Ave
Patchogue, NY 11772
Phone (631) 289-0338

10825 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 849-2321

125 Franklin Ave
Valley Stream, NY 11580
Phone (516) 825-7000

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1295721405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115579998",
            "telephone_number": "516-374-6838",
            "fax_number": "516-374-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115579998",
            "telephone_number": "516-374-6838",
            "fax_number": "516-374-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUPITER",
        "first_name": "BARRY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "131576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00803558",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

Verify at the official NPI Registry.