Active NPI
Robert Frederick Mazzeo, MD
- Family Medicine Physician
- Lake Ronkonkoma, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 162565
- Practice address
- 640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324 - Phone
- (631) 737-0100
- Fax
- (631) 737-0100
- NPI assigned
- Jul 3, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 162565 | NY | Primary |
Addresses
Primary practice location
640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324
Mailing address
55 Water Street
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888
Other practice location 1
1120 Little East Neck Road
West Babylon, NY 11704
Phone (631) 669-7712
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
- Family Practice
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324
Phone (631) 737-0100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162565 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantagecare Physicians PC | Current | Accepting new patients | |
| Advantagecare Physicians PC | Family Medicine | Current | Accepting new patients |
| Jeffrey M Nakhjavan DO PC | Family Medicine | Past | Accepting new patients |
Locations
233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595
55 Water St
Fl 2
New York, NY 10041
300 Bay Shore Rd
North Babylon, NY 11703
Phone (631) 586-2700
640 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 737-0100
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- rmazzeo16065@direct.acpny.com
- https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
Organizations & group practices 3
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.
-
dba AdvantageCare Physicians
- General Practice Physician
- New York, NY
- NPI 1336578772
-
dba AdvantageCare Physicians Urgent Care
- Internal Medicine Physician
- Staten Island, NY
- NPI 1063954113
Family Medicine
-
- Family Medicine Physician
- North Babylon, NY
- NPI 1578760005
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Peconic Bay Homehealth Services
- Home Health Agency
- Riverhead, NY
- NPI 1932155678
-
dba Catholic Health Home Care
- Home Health Agency
- Farmingdale, NY
- NPI 1780670711
-
dba Tender Loving Care, an Amedisys Company
- Home Health Agency
- Medford, NY
- NPI 1699715961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761523200000",
"number": "1043240534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WATER STREET",
"address_2": "2ND FLOOR CRED DEPT",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100410004",
"telephone_number": "646-680-2888",
"fax_number": "516-542-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 HAWKINS AVE",
"city": "LAKE RONKONKOMA",
"state": "NY",
"postal_code": "117792324",
"telephone_number": "631-737-0100",
"fax_number": "631-737-0100"
}
],
"practiceLocations": [
{
"address_1": "1120 Little East Neck Road",
"address_purpose": "LOCATION",
"city": "West Babylon",
"state": "NY",
"postal_code": "11704",
"country_code": "US",
"telephone_number": "631-669-7712",
"fax_number": "631-669-7718",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAZZEO",
"first_name": "ROBERT",
"middle_name": "FREDERICK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "162565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Ronkonkoma, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.