Jack Denaro, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

110624 Issued in NY

Practice address

1650 Champlin Ave
St. Luke's Home
New Hartford, NY 13413-1069

Phone

(315) 624-8600

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457464752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 STRATHMORE HALL ST",
            "address_2": "APT. 208",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208526689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 CHAMPLIN AVE",
            "address_2": "ST. LUKE'S HOME",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131069",
            "telephone_number": "315-624-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENARO",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "110624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110624",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert L Decarlo, MD
• Teresa M. Decker, LCSW-R
• Joseph a Decondo, PT, DPT
• Cathy Degarmo, MSPT
• Vinessa Deluke, FNP
• Denise Spagnola (Professional Counseling Center)
• James M Dennison
• Marc Deperno, OTR
• Samantha Deshaw, FNP
• Jenna Destito, PHARM D.

• Geriatric Medicine (Internal Medicine) Physician in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Geriatric Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.