Active NPI
Komal Dold
- Family Nurse Practitioner
- Bethpage, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 348241
- Practice address
- 4045 Hempstead Tpke
Bethpage, NY 11714-5611 - Phone
- (516) 731-7770
- NPI assigned
- Jan 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 718609-1 | NY | |
| Family Nurse Practitioner | 363LF0000X | 348241 | NY | Primary |
Addresses
Primary practice location
4045 Hempstead Tpke
Bethpage, NY 11714-5611
Mailing address
4045 Hempstead Tpke
Bethpage, NY 11714-5611
Phone (516) 731-7770
Other practice location 1
1500 NY-112 Building 2
Suite B
Port Jefferson Station, NY 11776
Phone (631) 978-7633
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580
26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 718609-1 | NY | MD | Registered Nurse |
| 348241 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients | |
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Past | Accepting new patients |
Locations
26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502
200 Motor Pkwy
Ste C16
Hauppauge, NY 11788
Phone (631) 638-4933
90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050
110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192
1500 Route 112
Ste B
Port Jefferson Station, NY 11776
Phone (631) 343-4184
75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
47 Commerce Ave
Ste 1
Riverhead, NY 11901
Phone (631) 978-7633
100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560
Philadelphia, PA 19195
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Organizations & group practices 5
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.
-
- Cardiac Rehabilitation Registered Nurse
- Stony Brook, NY
- NPI 1295778371
-
dba CareMount Medical, P.C.
- Cardiovascular Disease Physician
- Mount Kisco, NY
- NPI 1982643003
-
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
- NPI 1053190595
-
- Pulmonary Disease Physician
- Stony Brook, NY
- NPI 1104865229
-
- Medical Oncology Physician
- Stony Brook, NY
- NPI 1184679342
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Stony Brook Southampton Hospital
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1093251373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4045 HEMPSTEAD TPKE",
"city": "BETHPAGE",
"state": "NY",
"postal_code": "117145611",
"telephone_number": "516-731-7770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4045 HEMPSTEAD TPKE",
"city": "BETHPAGE",
"state": "NY",
"postal_code": "117145611",
"telephone_number": "516-731-7770"
}
],
"practiceLocations": [
{
"address_1": "1500 NY-112 Building 2",
"address_2": "Suite B",
"address_purpose": "LOCATION",
"city": "Port Jefferson Station",
"state": "NY",
"postal_code": "11776",
"country_code": "US",
"telephone_number": "631-978-7633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOLD",
"first_name": "KOMAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-11",
"last_updated": "2022-06-17",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "718609-1",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "348241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethpage, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.