Mario Joseph Capuano, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

045939 Issued in NY

Practice address

260 Middle Country Rd
BLDG 2 Suite 12
Selden, NY 11784-2568

Phone

(631) 696-9752

Fax

(631) 696-5096

NPI assigned

Jul 22, 2005

Last updated

Nov 11, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Specialty

Maxillofacial Surgery

Education

New York University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Long Island Oral and Maxillofacial Surgery Associates LLP

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Jefferson Station, NY
  • NPI 1801896667
  Authorized official Same address or phone

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1831199694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MIDDLE COUNTRY RD",
            "address_2": "BUILDING 2, SUITE 12",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842568",
            "telephone_number": "631-696-9752",
            "fax_number": "631-696-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MIDDLE COUNTRY RD",
            "address_2": "BLDG 2 SUITE 12",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842568",
            "telephone_number": "631-696-9752",
            "fax_number": "631-696-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUANO",
        "first_name": "MARIO",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "045939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lazarus Camesas, DDS
• Kathryn Anne Campanile
• Dawnmarie Canale
• Janelle Candelario
• Alexa Cappetta, DPT
• Caitlyn Marie Caputo
• Jessica Carney, MSED
• Harriet I Carty, CRNA
• Robert John Caruso II, PHARM.D
• Mikaela Carvalho

• Oral and Maxillofacial Surgery (Dentist) in Selden, NY
• Providers in Selden, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.