Brian Ghezelaiagh, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

312913 Issued in NY

Practice address

2500 Nesconset Hwy BLDG 17C
Stony Brook, NY 11790-2563

Phone

(631) 210-6305

Fax

(631) 292-7376

NPI assigned

Apr 12, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

State University of New York Downstate Medical Center, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brian Ghezelaiagh, MD, PCGroup PAC ID 6002258746, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Brian Ghezelaiagh, MD, PC

  • Psychiatry Physician
  • Stony Brook, NY
  • NPI 1659140747

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1033616206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 17C",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902563",
            "telephone_number": "631-210-6305",
            "fax_number": "631-292-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 17C",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902563",
            "telephone_number": "631-210-6305",
            "fax_number": "631-292-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEZELAIAGH",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "312913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Geralemou, MD
• Deborah Ann Gerard, BCBA
• Colby Germann
• Anish Ghai
• Nimra Ghani, MD
• Wendy Ghezelaiagh, DDS
• Peter James Giacopelli, R.PH.
• Stefanos Giannopoulos, MD
• Gideon L Schneck MD PC
• Christopher Gidicsin, MD

• Psychiatry Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.