Individual provider Active NPI

Joseph Dimauro, PA

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1730330358
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006930 Issued in NY
Practice address
94 Scranton Ave
Staten Island, NY 10312-3212
Phone
(718) 227-1007
NPI assigned
Oct 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006930 NY Primary

Addresses

Primary practice location

94 Scranton Ave
Staten Island, NY 10312-3212

Mailing address

94 Scranton Ave
Staten Island, NY 10312-3212
Phone (718) 227-1007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090312000388 NY Practitioner - Physician Assistant 8022174234 Reassigns benefits to 2 organizations
I20200220001168 NJ Practitioner - Physician Assistant 8022174234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1771 Madison Ave
Lakewood, NJ 08701-1242
Phone (732) 364-2144

1771 Madison Ave
Lakewood, NJ 08701-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006930NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Lakewood Resource and Referral Center Inc CurrentSince Jul 1, 2025 Accepting new patients
Physicians of University Hospital, PC CurrentSince Sep 1, 2010 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

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

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1730330358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 SCRANTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123212",
            "telephone_number": "718-227-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 SCRANTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123212",
            "telephone_number": "718-227-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMAURO",
        "first_name": "JOSEPH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.