Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. John A Procaccino Jr., MD

Individual provider Surgery Physician · NPI 1114997939

Dr. John A Procaccino Jr., MD is a Colorectal Surgery (Proctology) in Great Neck, New York. Graduated from New York Medical College in 1984, 42 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
42
Trained at
New York Medical College
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

900 Northern Blvd
Great Neck, NY 11021-5302
Phone: (516) 730-2100
Fax: (516) 730-2121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 171315 (NY)

Record details

NPI number1114997939
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 24, 2006
Last updated in NPPESSeptember 23, 2013
Mailing address972 Brush Hollow Rd, Westbury, NY 11590-1740

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCOLORECTAL SURGERY (PROCTOLOGY)
Also practisesGENERAL SURGERY
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 1984 (42 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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