Individual provider Active NPI

Javier Depaz, MD

  • Neonatal-Perinatal Medicine Physician
  • Richmond Hill, NY
National Provider Identifier
1396707956
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
250320 Issued in NY
Practice address
8900 Van Wyck Expy
Richmond Hill, NY 11418-2832
Phone
(718) 206-6175
Fax
(718) 206-6915
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 000974 NY
Neonatal-Perinatal Medicine Physician 2080N0001X 000974 NY
Neonatal-Perinatal Medicine Physician 2080N0001X 250320 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Richmond Hill, NY 11418-2832

Mailing address

116 N 7TH St
New Hyde Park, NY 11040-3027
Phone (718) 206-6175

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
I20040414001490 NY Practitioner - Pediatric Medicine 8022002609 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000974NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Aug 17, 2009 Accepting new patients
Jamaica Hospital CurrentSince Aug 17, 2009 Accepting new patients
TJH Medical Services, P.C. Pediatrics CurrentSince Apr 1, 2012 Accepting new patients
Jamaica Hospital Past Accepting new patients
JHMC Diagnostic and Treatment Center Pediatrics Past Accepting new patients

Locations

3080 Atlantic Ave
Brooklyn, NY 11208
Phone (718) 647-0240

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: jdepaz6742@direct.medisys.org

Organizations & group practices 5

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1396707956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N 7TH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403027",
            "telephone_number": "718-206-6175",
            "fax_number": "718-206-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182832",
            "telephone_number": "718-206-6175",
            "fax_number": "718-206-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAZ",
        "first_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "000974",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "000974",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "250320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.