Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. John Robert Dimartino, MD

Individual provider Family Medicine Physician · NPI 1104901057

Dr. John Robert Dimartino, MD is a Family Practice in Massapequa, New York. Qualified in 1980, 46 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
46
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

747 N Broadway
Massapequa, NY 11758-2395
Phone: (516) 795-5200
Fax: (516) 795-3865
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 157041 (NY)

Record details

NPI number1104901057
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 26, 2006
Last updated in NPPESJuly 16, 2015
Mailing address747 N Broadway, Suite 1, Massapequa, NY 11758-2395

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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