Individual provider Active NPI

John Boccio, D.O.

  • Family Medicine Physician
  • Bethpage, NY
National Provider Identifier
1396744504
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
204111 Issued in NY
Practice address
530 Hicksville Rd
Bethpage, NY 11714-3415
Phone
(516) 937-5000
Fax
(516) 931-2535
NPI assigned
Jul 19, 2005
Last updated
Jun 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 204111 NY Primary

Addresses

Primary practice location

530 Hicksville Rd
Bethpage, NY 11714-3415

Mailing address

530 Hicksville Rd
Bethpage, NY 11714-3415
Phone (516) 937-5000

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
I20040518001412 NY Practitioner - Family PracticePractitioner - Emergency Medicine 4688665854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.19 of 100Reported as group
Quality
82.16
Promoting interoperability
79
Improvement activities
40
Cost
75.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204111NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Jamaica Hospital CurrentSince Oct 12, 2009 Accepting new patients
Jamaica Hospital CurrentSince Oct 12, 2009 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients
Long Island Primary Medical Care Past Accepting new patients

Locations

530 Hicksville Rd
Bethpage, NY 11714
Phone (516) 937-3511

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

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

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

Networks

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

Organizations & group practices 7

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1396744504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 HICKSVILLE RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143415",
            "telephone_number": "516-937-5000",
            "fax_number": "516-931-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 HICKSVILLE RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143415",
            "telephone_number": "516-937-5000",
            "fax_number": "516-931-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCCIO",
        "first_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "204111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.