Individual provider Active NPI

Kathleen Doobinin, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Stony Brook, NY
National Provider Identifier
1043231939
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
60-256435 Issued in NY
Practice address
Department of Pediatrics
HSC T-11-020
Stony Brook, NY 11794-8111
Phone
(631) 444-2710
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60-256435 NY
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 60-256435 NY Primary

Addresses

Primary practice location

Department of Pediatrics
HSC T-11-020
Stony Brook, NY 11794-8111

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-0650

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
I20100721000641 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8921130246 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60-256435NYMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Pediatrics CurrentSince Jul 1, 2010 Accepting new patients
Childrens Specialty Group PLLC Pediatrics Past Accepting new patients

Locations

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

Networks

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

Interoperability endpoints

  • Direct secure messaging: kathleen.doobinin@direct.stonybrookmedicine.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1043231939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PEDIATRICS",
            "address_2": "HSC T-11-020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOBININ",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "60-256435",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "60-256435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.