Individual provider Active NPI

Johanna Marie Pacheco, M.D.

  • Hospitalist Physician
  • Huntington, NY
National Provider Identifier
1891082681
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
276825 Issued in NY
Practice address
270 Park Ave
Huntington, NY 11743-2787
Phone
(631) 351-2255
Fax
(631) 760-2182
NPI assigned
Jun 30, 2011
Last updated
Aug 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 276825 NY Primary

Addresses

Primary practice location

270 Park Ave
Huntington, NY 11743-2787

Mailing address

8 Horizon Dr
Huntington, NY 11743-4411
Phone (646) 673-6306

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
I20150211000119 NY Practitioner - Hospitalist 7416272612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2356

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
276825NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Hospitalist CurrentSince Feb 1, 2020 Accepting new patients
Huntington Hospital Association Current Accepting new patients
Huntington Hospital Association CurrentSince Oct 1, 2014 Accepting new patients
Huntington Hospital Association CurrentSince Oct 1, 2014 Accepting new patients
Huntington Hospital Association Past Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

300 Community Dr
Manhasset, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1891082681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HORIZON DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434411",
            "telephone_number": "646-673-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432787",
            "telephone_number": "631-351-2255",
            "fax_number": "631-760-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JOHANNA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "276825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.