Active NPI
Robert J Maccone, MD
- Family Medicine Physician
- East Islip, NY
National Provider Identifier
1811080617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 146450
- Practice address
- 45 East Main Street
East Islip, NY 11730 - Phone
- (631) 581-0737
- Fax
- (631) 581-0729
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 146450 | NY | Primary |
Addresses
Primary practice location
45 East Main Street
East Islip, NY 11730
Mailing address
100 Hospital Rd 203
East Patchogue, NY 11772-8814
Phone (631) 475-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00756221 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080501000391 | NY | Practitioner - Family Practice | 7618056698 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1811080617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL RD 203",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117728814",
"telephone_number": "631-475-6900",
"fax_number": "631-447-5954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 EAST MAIN STREET",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "11730",
"telephone_number": "631-581-0737",
"fax_number": "631-581-0729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCONE",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "146450",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00756221",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Islip, NY
- Long Island Medical Diagnostic Imaging, PC (Zilkha Radiology)
- Long Island Medical Imaging, PC (d/b/a Zilkha Radiology)
- Carol Yei Luck, M.D.
- Victoria Lynam, LMSW
- Alexandra Marie Macchia
- Madeline Shakin DDS Kevin Sheren DDS PC
- Michael Madrigal, LMT
- Richard Maiorella, LCSW
- Matthew F Mangione, PT
- Tracy Lynn Marino, LMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.