DR. JOHN CONCANNON DO
NPI 1962409128
Pediatrics in Cranston, RI
About Dr. John Concannon Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN CONCANNON DO (NPI 1962409128) is an individual pediatrics provider in Cranston, Rhode Island, licensed in Rhode Island (DO-00357) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.
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 (PECOS)
Dr. John Concannon Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show John Concannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cranston, RI 02920
- Reassigned Medicare billing, Rhode Island enrollment
- 2 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02920 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CRANSTON, RI 02920
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 Concannon's NPI number?
The NPI number for John Concannon is 1962409128. It was assigned to this individual provider in the NPPES registry on July 2, 2005.
Where is John Concannon located?
John Concannon practices at 1145 Reservoir Ave Suite 124, Cranston, RI 02920. The listed phone number is (401) 943-7337.
What is John Concannon's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is John Concannon enrolled in Medicare?
Yes. John Concannon is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for John Concannon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Concannon reassigns Medicare benefits to Drs. Concannon And Vitale, LLC (Cranston, RI). 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 Concannon'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 Concannon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Dr. John Concannon, DO · NPI 1962409128
Pediatrics physician in Cranston, Rhode Island. Individual provider, active in the CMS NPPES registry since July 2, 2005.
## Identity
- **NPI:** 1962409128 (Entity type: Individual)
- **Enumerated:** July 2, 2005
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** DO-00357 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 1145 RESERVOIR AVE, SUITE 124, Cranston, RI 02920-6055
- **Phone:** (401) 943-7337 · **Fax:** (401) 942-1509
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Drs. Concannon And Vitale, LLC (NPI 1366402018, Cranston, RI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare UPIN C90437 (RI)
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Source: [NPI Profile](https://npiprofile.com/npi/1962409128) · Data from the CMS NPPES public registry.