JOHN IMPELLIZERI D.O
NPI 1669466363
Internal Medicine in Mattituck, NY
About John Impellizeri D.o NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN IMPELLIZERI D.O (NPI 1669466363) is an individual internal medicine provider in Mattituck, New York, licensed in New York (224524) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (1999).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
John Impellizeri D.o is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show John Impellizeri reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92120
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11952 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Impellizeri's NPI number?
The NPI number for John Impellizeri is 1669466363. It was assigned to this individual provider in the NPPES registry on September 8, 2005.
Where is John Impellizeri located?
John Impellizeri practices at 13400 Main Rd, Mattituck, NY 11952. The listed phone number is (631) 298-4008.
What is John Impellizeri's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is John Impellizeri enrolled in Medicare?
Yes. John Impellizeri is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for John Impellizeri's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Impellizeri reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Impellizeri's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for John Impellizeri was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# John Impellizeri, D.O · NPI 1669466363
Internal Medicine physician in Mattituck, New York. Individual provider, active in the CMS NPPES registry since September 8, 2005.
## Identity
- **NPI:** 1669466363 (Entity type: Individual)
- **Enumerated:** September 8, 2005
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 224524 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 13400 MAIN RD, Mattituck, NY 11952-3209
- **Phone:** (631) 298-4008 · **Fax:** (631) 298-5969
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1225060742, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York College Of Osteo Medicine Of New York Institute Of Technology, class of 1999
## Record status
- **NPPES last updated:** November 18, 2021
- **Other identifiers:** Medicaid 02444824 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1669466363) · Data from the CMS NPPES public registry.