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

John Impellizeri, DO

Individual provider Internal Medicine Physician · NPI 1669466363

John Impellizeri, DO is an Internal Medicine in Mattituck, New York. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 1999, 27 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
27
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
NY
In the registry since
2005
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

13400 Main Rd
Mattituck, NY 11952-3209
Phone: (631) 298-4008
Fax: (631) 298-5969
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 224524 (NY)

Record details

NPI number1669466363
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 8, 2005
Last updated in NPPESNovember 18, 2021

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 1999 (27 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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