Individual provider Active NPI

John Minutillo, M.D

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1588639751
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
196818 Issued in NY
Practice address
90 E End Ave
New York, NY 10028-8000
Phone
(212) 734-8877
Fax
(212) 734-2366
NPI assigned
Feb 21, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 196818 NY Primary
Nuclear Cardiology Physician 207UN0901X 196818 NY

Addresses

Primary practice location

90 E End Ave
New York, NY 10028-8000

Mailing address

90 E End Ave
New York, NY 10028-8000
Phone (212) 734-8877

Other identifiers 1

IdentifierTypeStateIssuer
01-0597943OtherNYTAX ID

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
I20041117000274 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5496719643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

158 E 84TH St
New York, NY 10028-2005
Phone (212) 452-9201

1601 County Rd
Suite 39
Southampton, NY 11968-5295
Phone (631) 283-2070

2649 Strang Blvd
Yorktown Heights, NY 10598-2939
Phone (212) 434-3000

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196818NYMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LH Emergency Medical Services PC Past Accepting new patients
Travel Medicine Consultations, PC PastSince Aug 14, 2022 Accepting new patients
Avenue Medical Associates PC PastSince Aug 14, 2022 Accepting new patients

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24161/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jminutillo64602@northwell.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1588639751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100288000",
            "telephone_number": "212-734-8877",
            "fax_number": "212-734-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100288000",
            "telephone_number": "212-734-8877",
            "fax_number": "212-734-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINUTILLO",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "196818",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NY",
            "license": "196818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "01-0597943",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.