Individual provider Active NPI

John Joseph De Caro, MD

  • Urology Physician
  • Lansdale, PA
National Provider Identifier
1366601585
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD463353 Issued in PA
Practice address
125 Medical Campus Dr Ste 305
Lansdale, PA 19446-7205
Phone
(215) 361-2304
NPI assigned
Jun 3, 2008
Last updated
Jul 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 074725 GA
Urology Physician 208800000X MD463353 PA Primary

Addresses

Primary practice location

125 Medical Campus Dr Ste 305
Lansdale, PA 19446-7205

Mailing address

2500 Maryland Rd Ste 400
Willow Grove, PA 19090-1225
Phone (215) 481-4143

Other practice location 1

711 Lawn Ave Ste 2
Sellersville, PA 18960-1575
Phone (215) 257-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170223001835 GA Practitioner - Urology 6406086834 Reassigns benefits to 1 organization
I20181001001038 PA Practitioner - Urology 6406086834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Stanford University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

20 Glenlake Pkwy
Atlanta, GA 30328-3473
Phone (770) 677-6043

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026

750 Townpark LN NW
Kennesaw, GA 30144-5579
Phone (770) 514-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD463353PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Nov 11, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Nov 11, 2021 Accepting new patients
The Southeast Permanente Medical Group Urology CurrentSince Feb 1, 2017 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1366601585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARYLAND RD STE 400",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901225",
            "telephone_number": "215-481-4143",
            "fax_number": "215-481-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEDICAL CAMPUS DR STE 305",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194467205",
            "telephone_number": "215-361-2304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Lawn Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Sellersville",
            "state": "PA",
            "postal_code": "189601575",
            "country_code": "US",
            "telephone_number": "215-257-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE CARO",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "074725",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD463353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.