Organization Active NPI

Richmond Total Medical, P.C.

  • General Practice Physician
  • Staten Island, NY
National Provider Identifier
1730218363
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
211722 Issued in NY
Legal business name
RICHMOND TOTAL MEDICAL, P.C.
Practice address
1776 Richmond Rd
Suite 5
Staten Island, NY 10306-2581
Phone
(718) 668-9300
Fax
(718) 668-1834
NPI assigned
Mar 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Dominick McCarthy, D.O.NPI 1235103342
Title
President
Phone
(718) 317-5960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 211722 NY Primary

Addresses

Primary practice location

1776 Richmond Rd
Suite 5
Staten Island, NY 10306-2581

Mailing address

131 Hillside Ter
Staten Island, NY 10308-2819
Phone (718) 317-5960

Other identifiers 1

IdentifierTypeStateIssuer
02060699MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070717000651 NY Part B Supplier - Clinic/Group Practice 9638279805 Receives reassigned benefits from 2 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Locations

1776 Richmond Rd
Ste 5
Staten Island, NY 10306
Phone (718) 668-9300

3000 Hylan Blvd
Staten Island, NY 10306
Phone (718) 668-9300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730218363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HILLSIDE TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082819",
            "telephone_number": "718-317-5960",
            "fax_number": "718-317-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 RICHMOND RD",
            "address_2": "SUITE 5",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062581",
            "telephone_number": "718-668-9300",
            "fax_number": "718-668-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND TOTAL MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DOMINICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-317-5960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "211722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02060699",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.