Individual provider Active NPI

John P Dodaro, MD

  • Otolaryngology Physician
  • Staten Island, NY
National Provider Identifier
1407817562
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
191172 Issued in NY
Practice address
1 Teleport Dr Ste 200
Staten Island, NY 10311-1000
Phone
(718) 370-0072
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA06414200 NJ
Otolaryngology Physician 207Y00000X 191172 NY Primary

Addresses

Primary practice location

1 Teleport Dr Ste 200
Staten Island, NY 10311-1000

Mailing address

660 White Plains Rd FL 4
Tarrytown, NY 10591-5139
Phone (914) 984-2546

Other practice location 1

3663 Route 9 N Ste 102
Old Bridge, NJ 08857-3518
Phone (732) 679-7575

Other identifiers 1

IdentifierTypeStateIssuer
01840151MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20040831000871 NJ Practitioner - Otolaryngology 7012982267 Reassigns benefits to 1 organization
I20060517000113 NY Practitioner - Otolaryngology 7012982267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Icahn School of Medicine at Mount Sinai, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

1 Teleport Dr
Suite 200
Staten Island, NY 10311-1000
Phone (718) 370-0072

1086 N Broadway
Suite 220
Yonkers, NY 10701-1112
Phone (914) 963-8588

1211 Hamburg Tpke
Suite 205
Wayne, NJ 07470-5056
Phone (973) 633-0808

3663 Route 9 N
Suite 102
Old Bridge, NJ 08857-3518
Phone (732) 679-7575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
89.91
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06414200NJMDOtolaryngology Physician
191172NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates LLP Otolaryngology CurrentSince Nov 1, 2013 Accepting new patients
ENT and Allergy Associates of Pennsylvania PLLC Otolaryngology Past Accepting new patients
Staten Island Physician Practice PC Past Accepting new patients
The Eye Ear Nose and Throat Institute, Inc. Past Accepting new patients

Locations

3663 Route 9 N
Ste 102
Old Bridge, NJ 08857
Phone (732) 679-7575

1211 Hamburg Tpke
Ste 205
Wayne, NJ 07470
Phone (973) 633-0808

1 Teleport Dr
Ste 200
Staten Island, NY 10311
Phone (718) 370-0072

660 White Plains Rd
Fl 4
Tarrytown, NY 10591
Phone (914) 984-2546

1086 N Broadway
Ste 220
Yonkers, NY 10701
Phone (914) 279-9500

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: john.dodaro@direct.entandallergy.nextgenshare.com

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.

Hospital & facility affiliations 5

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1407817562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-984-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TELEPORT DR STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103111000",
            "telephone_number": "718-370-0072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3663 Route 9 N Ste 102",
            "address_purpose": "LOCATION",
            "city": "Old Bridge",
            "state": "NJ",
            "postal_code": "088573518",
            "country_code": "US",
            "telephone_number": "732-679-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODARO",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA06414200",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "191172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01840151",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.