Individual provider Active NPI

Michael Joseph Digiovanna, D.O.

  • Internal Medicine Physician
  • North Massapequa, NY
National Provider Identifier
1043222755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1753621 Issued in NY
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01501091MedicaidNY

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
I20110303000507 NY Practitioner - Internal Medicine 7517149164 Reassigns benefits to 1 organization

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
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

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 Home health agency, Farmingdale, NY, CCN 337147

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1753621NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince May 15, 2020 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.