Individual provider Active NPI

Nicoleta Ionica, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Bay Shore, NY
National Provider Identifier
1033388376
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
267316 Issued in NY
Practice address
180 E Main St
Bay Shore, NY 11706-8427
Phone
(631) 780-7800
NPI assigned
Feb 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD12853 RI
Student in an Organized Health Care Education/Training Program 390200000X MD
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 267316 NY Primary

Addresses

Primary practice location

180 E Main St
Bay Shore, NY 11706-8427

Mailing address

180 E Main St
Bay Shore, NY 11706-8427
Phone (631) 780-7800

Other identifiers 1

IdentifierTypeStateIssuer
A400079047OtherNYMEDICARE

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
I20130117000227 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 1850479106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

301 E Main St
Bay Shore, NY 11706-8408

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD12853RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Theofanis Mitsinikos, DO, PC Endocrinology, Diabetes & Metabolism CurrentSince May 1, 2017 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Aug 20, 2018 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

2500 Nesconset Hwy
Bldg 3C
Stony Brook, NY 11790
Phone (631) 751-2400

6144 Route 25A
Ste C
Wading River, NY 11792
Phone (631) 369-5000

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: nionica65389@northwell.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1033388376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068427",
            "telephone_number": "631-780-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068427",
            "telephone_number": "631-780-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IONICA",
        "first_name": "NICOLETA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD12853",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "267316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400079047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.