Individual provider Active NPI

Bridget A. Nozdrovicky, P.A.

  • Physician Assistant
  • Stony Brook, NY
National Provider Identifier
1053407346
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010779 Issued in NY
Practice address
Dept of Med/Cardiology HSC T16-080
Stony Brook University
Stony Brook, NY 11794-0001
Phone
(631) 444-1106
Fax
(631) 444-2493
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010779 NY Primary

Addresses

Primary practice location

Dept of Med/Cardiology HSC T16-080
Stony Brook University
Stony Brook, NY 11794-0001

Mailing address

Dept of Med/Cardiology HSC T16-080
Stony Brook University
Stony Brook, NY 11794-0001
Phone (631) 444-1106

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070410000526 NY Practitioner - Physician Assistant 9931204575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 941-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 28, 2008 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: bridget.nozdrovicky@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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1053407346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT OF MED/CARDIOLOGY HSC T16-080",
            "address_2": "STONY BROOK UNIVERSITY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-1106",
            "fax_number": "631-444-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT OF MED/CARDIOLOGY HSC T16-080",
            "address_2": "STONY BROOK UNIVERSITY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-1106",
            "fax_number": "631-444-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOZDROVICKY",
        "first_name": "BRIDGET",
        "middle_name": "A.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.