Individual provider Active NPI

Anthony Rocco De Marco, DDS

  • Dentist
  • Farmingville, NY
National Provider Identifier
1881897056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
042905 Issued in NY
Practice address
63 Beech Avenue
Farmingville, NY 11738-1629
Phone
(631) 220-0073
NPI assigned
Jun 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042905 NY Primary

Addresses

Primary practice location

63 Beech Avenue
Farmingville, NY 11738-1629

Mailing address

63 Beech Avenue
Farmingville, NY 11738-1629
Phone (631) 220-0073

Other identifiers 1

IdentifierTypeStateIssuer
01653112020MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160105001841 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911209119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881897056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BEECH AVENUE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381629",
            "telephone_number": "631-220-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BEECH AVENUE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381629",
            "telephone_number": "631-220-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MARCO",
        "first_name": "ANTHONY",
        "middle_name": "ROCCO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01653112020",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingville, NY

Sources for this page

Verify at the official NPI Registry.