Individual provider Active NPI

John A. D'Anna, MD

  • Surgery Physician
  • Staten Island, NY
National Provider Identifier
1578549820
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
136636 Issued in NY
Practice address
256 Mason Ave
Staten Island, NY 10305-3408
Phone
(718) 226-6398
Fax
(718) 226-6911
NPI assigned
Dec 19, 2005
Last updated
Mar 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 136636 NY Primary

Addresses

Primary practice location

256 Mason Ave
Staten Island, NY 10305-3408

Mailing address

1 Edgewater St
6TH Floor
Staten Island, NY 10305-4900
Phone (718) 226-4324

Other identifiers 1

IdentifierTypeStateIssuer
00806813MedicaidNY

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
I20100429000975 NY Practitioner - Vascular SurgeryPractitioner - General Surgery 1951438589 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013636NYMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 1, 2018 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

1 Edgewater St
Staten Island, NY 10305
Phone (718) 226-1008

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

256 Mason Ave
Staten Island, NY 10305
Phone (718) 226-9508

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 1

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1578549820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER ST",
            "address_2": "6TH FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054900",
            "telephone_number": "718-226-4324",
            "fax_number": "718-226-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6398",
            "fax_number": "718-226-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANNA",
        "first_name": "JOHN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "136636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00806813",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.