Stafford D John, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

020469 Issued in NY

Practice address

3435 70TH St
Jackson Heights, NY 11372-1055

Phone

(718) 651-9700

Fax

(718) 533-0264

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Jamaica Hillside Dialysis Dialysis facility, Jamaica, NY, CCN 332766
• DaVita Queens Dialysis Center Dialysis facility, Jamaica, NY, CCN 332583
• FMS-South Queens Dialysis Center Dialysis facility, Jamaica, NY, CCN 332531
• Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

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

Interoperability endpoints

• Direct secure messaging: stafford.john@direct.davitaphysiciansolutions.com
• Direct secure messaging: sjohn11440@nychhc.direct-ci.com

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.

• Premier Nephrology Services PC

  • Medical Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1083992317
  NPD (past) Authorized official
• South Queens Nephrology Associates

  • Specialist
  • Jamaica, NY
  • NPI 1255316246
  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465
  NPD (past)

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

• Knickerbocker Dialysis Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jamaica, NY
  • NPI 1942654694

  Dialysis facility

  Care Compare affiliation Name & address match
• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1508842261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 REMSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361227",
            "telephone_number": "718-345-9106",
            "fax_number": "718-533-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 70TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721055",
            "telephone_number": "718-651-9700",
            "fax_number": "718-533-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "STAFFORD",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "020469",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "020469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01918556",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonia Ann Jimenez, R.N.
• Hosneara Jinnat, MD
• Jitendra N Tolia MD PC
• JMM Pharmacy Inc
• Sanu John
• Asia Jones
• Gifta Laurel Jones, PHARM.D
• Jose I Rodriguez-Ospina MD PC
• Jose M Mendez MD PC
• JS Optical Corp

• Nephrology Physician in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.