Joseph Depra, MD
Individual provider Active NPI Family Medicine Physician · Wayland, NY
NPI 1851379929 · NPPES record last updated Jun 1, 2015
Key facts
- NPI
- 1851379929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 181792-1 (NY)
- Practice address
- 200 N Main St
Wayland, NY 14572-1034 - Phone
- (585) 728-5131
- Fax
- (585) 728-9305
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Temple University School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri-County Family Medicine Program, Inc.
Practice addresses (Care Compare)
10869 State Route 36
Dansville, NY 14437-9444
Phone (585) 335-3100
200 N Main St
Wayland, NY 14572-1034
Phone (585) 728-5131
Hospital & facility affiliations
- Carefirst / Southern Tier Hospice and Palliative
- Livingston County Hospice
- Nicholas H Noyes Memorial Hospital
- St James Hospital
- Strong Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100211000139 | NY | Practitioner - Family Practice |
1759424864 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 181792-1 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-County Family Medicine Program, Inc. | Family Medicine | Current |
Accepting new patients |
| Joseph a Depra, Physician, PLLC | Current | Accepting new patients | |
| Tri-County Family Medicine Program, Inc. | Current |
Accepting new patients | |
| Nicholas H. Noyes Memorial Hospital | Past | Accepting new patients |
Locations
25 Park Ave
Cohocton, NY 14826
Phone (585) 384-5310
10869 State Route 36
Dansville, NY 14437
Phone (585) 335-3100
60 Red Jacket St
Ste 1
Dansville, NY 14437
Phone (585) 335-6041
111 Clara Barton St
Dansville, NY 14437
Phone (585) 335-3100
50 E South St
Ste 700
Geneseo, NY 14454
Phone (585) 243-1700
200 N Main St
Wayland, NY 14572
Phone (585) 728-2044
Interoperability endpoints
- josephmd.depra@tfmpi.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 181792-1 | NY | Yes |
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 181792 | NY |
Addresses
Primary practice location
200 N Main St
Wayland, NY 14572-1034
Mailing address
PO Box 601
10869 Rte 36 South
Dansville, NY 14437-0601
Phone (585) 335-3416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01282306 | Medicaid | NY | |
| 181792 | Other | NY | PREFERRED CARE |
Other providers in Wayland, NY
- Betsy Ann Clawson
- Daniel Curtin
- CVS Albany, L.L.C.
- Erin Dabney
- Deborah L. Schafer, P.C.
- Luanne Dockstader
- Joan Marie Dubrule
- Anita Eck
- Simona Disree English
- Patricia Scott Fitzpatrick
All providers in Wayland, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.