Active NPI
Michael Joseph Digiovanna, D.O.
- Internal Medicine Physician
- North Massapequa, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 1753621
- Practice address
- 1061 N Broadway
North Massapequa, NY 11758-1802 - Phone
- (516) 420-4300
- Fax
- (516) 420-0730
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1753621 | NY | Primary |
Addresses
Primary practice location
1061 N Broadway
North Massapequa, NY 11758-1802
Mailing address
1061 N Broadway
North Massapequa, NY 11758-1802
Phone (516) 420-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01501091 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1061 N Broadway
Suite 2
North Massapequa, NY 11758-1853
Phone (631) 751-3000
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
Hospital & facility affiliations
- Catholic Home Care
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1753621 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Hematology Oncology Associates PC | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1061 N Broadway
North Massapequa, NY 11758
Phone (516) 420-4300
1061 N Broadway
Ste 2
North Massapequa, NY 11758
Phone (516) 420-4300
1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354
1500 Route 112
Bldg 2
Port Jefferson Station, NY 11776
Phone (631) 626-4737
48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
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.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Farmingdale, NY
- NPI 1780670711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043222755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 N BROADWAY",
"city": "NORTH MASSAPEQUA",
"state": "NY",
"postal_code": "117581802",
"telephone_number": "516-420-4300",
"fax_number": "516-420-0730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 N BROADWAY",
"city": "NORTH MASSAPEQUA",
"state": "NY",
"postal_code": "117581802",
"telephone_number": "516-420-4300",
"fax_number": "516-420-0730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIGIOVANNA",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "1753621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01501091",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Massapequa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.