Individual provider Active NPI

John Manning Carson, M.D.

  • Nephrology Physician
  • Mineola, NY
National Provider Identifier
1578724787
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
291345 Issued in NY
Practice address
200 Old Country Rd Ste 135
Mineola, NY 11501-4237
Phone
(516) 663-2169
Fax
(516) 663-2179
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 291345 NY Primary

Addresses

Primary practice location

200 Old Country Rd Ste 135
Mineola, NY 11501-4237

Mailing address

200 Old Country Rd Ste 135
Mineola, NY 11501-4237
Phone (516) 663-2169

Other identifiers 2

IdentifierTypeStateIssuer
023865OtherCOKAISER COMMERCIAL NUMBER
80284272MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcarson233001@nyumc.direct-ci.com

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
I20171221002589 NY Practitioner - Nephrology 0840427100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Jefferson Medical College of Thomas Jefferson University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

200 Old Country Rd
Mineola, NY 11501-4237

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

  • NYU Winthrop Hospital Dialysis Mineola Dialysis facility, Mineola, NY, CCN 332336
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
New York University Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates PC Internal Medicine Past Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology PastSince Sep 20, 2020 Accepting new patients

Locations

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

200 Old Country Rd
Ste 135
Mineola, NY 11501
Phone (516) 663-2169

200 Old Country Rd
Ste 370
Mineola, NY 11501
Phone (516) 541-0300

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHACA

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 8

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1578724787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD STE 135",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014237",
            "telephone_number": "516-663-2169",
            "fax_number": "516-663-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD STE 135",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014237",
            "telephone_number": "516-663-2169",
            "fax_number": "516-663-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JOHN",
        "middle_name": "MANNING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "291345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "023865",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80284272",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcarson233001@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "200 Old Country Rd Ste 135",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.