Individual provider Active NPI

Charmian Darryl Cohen, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Riverhead, NY
National Provider Identifier
1003929043
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
161564-1 Issued in NY
Practice address
632 Roanoke Ave
Riverhead, NY 11901-2728
Phone
(631) 939-2127
Fax
(718) 892-0736
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 161564-1 NY Primary

Addresses

Primary practice location

632 Roanoke Ave
Riverhead, NY 11901-2728

Mailing address

632 Roanoke Ave
Riverhead, NY 11901-2728
Phone (631) 939-2127

Other identifiers 1

IdentifierTypeStateIssuer
00959059MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040517001261 NY Practitioner - Internal MedicinePractitioner - Endocrinology 6305836610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

632 Roanoke Ave
Riverhead, NY 11901-2728
Phone (631) 939-2127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
161564-1NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes & Endocrine PLLC Endocrinology, Diabetes & Metabolism CurrentSince Oct 1, 2021 Accepting new patients

Locations

1200 Waters Pl
Ste M105
Bronx, NY 10461
Phone (718) 792-4500

632 Roanoke Ave
Riverhead, NY 11901
Phone (631) 208-8270

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1003929043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012728",
            "telephone_number": "631-939-2127",
            "fax_number": "718-892-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012728",
            "telephone_number": "631-939-2127",
            "fax_number": "718-892-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "CHARMIAN",
        "middle_name": "DARRYL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "161564-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00959059",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.