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

Dr. John Depetrillo Jr., MD

Individual provider Internal Medicine Physician · NPI 1013127562

Dr. John Depetrillo Jr., MD is an Internal Medicine in Forest Hills, New York. Qualified in 2005, 21 years ago. Practices with Ccmma Nj LLC, a 30-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
21
Licensed in
NY
In the registry since
2007
Specialties on file
3
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

10201 66th Rd
Forest Hills, NY 11375-2029
Phone: (718) 830-4359
Fax: (718) 830-1015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Medicine (Internal Medicine) Physician (primary) Taxonomy 207RC0200X · Licence 250815 (NY)
Internal Medicine Physician Taxonomy 207R00000X · Licence 250815-1 (NY)
Infectious Disease Physician Taxonomy 207RI0200X · Licence 250815-1 (NY)

Record details

NPI number1013127562
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 23, 2007
Last updated in NPPESSeptember 2, 2014
Mailing address2249 35th St, Apt 1, Astoria, NY 11105-2206

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Also practisesCRITICAL CARE (INTENSIVISTS)
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Ccmma Nj Llc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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