Individual provider Active NPI

Lucy Moussignac, MD

  • Family Medicine Physician
  • Sag Harbor, NY
National Provider Identifier
1104402643
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
331017 Issued in NY
Practice address
3330 Noyac Rd BLDG a
Sag Harbor, NY 11963-1931
Phone
(631) 725-2112
Fax
(631) 725-7180
NPI assigned
Mar 23, 2021
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 331017 NY Primary

Addresses

Primary practice location

3330 Noyac Rd BLDG a
Sag Harbor, NY 11963-1931

Mailing address

4 Springville Rd Ste B
Hampton Bays, NY 11946-2290
Phone (631) 725-2112

Other practice location 1

147 Beach Rd Ste A
Westhampton Beach, NY 11978-1733
Phone (631) 288-7746

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
I20240822000041 NY Practitioner - Family Practice 0941749949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

3330 Noyac Rd
Sag Harbor, NY 11963-1930
Phone (631) 725-2112

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC CurrentSince Aug 26, 2024 Accepting new patients

Locations

4 Springville Rd
Ste B
Hampton Bays, NY 11946

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

147 Beach Rd
Ste A
Westhampton Beach, NY 11978
Phone (631) 288-7746

Networks

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1104402643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SPRINGVILLE RD STE B",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462290",
            "telephone_number": "631-725-2112",
            "fax_number": "631-725-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NOYAC RD BLDG A",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119631931",
            "telephone_number": "631-725-2112",
            "fax_number": "631-725-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Beach Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Westhampton Beach",
            "state": "NY",
            "postal_code": "119781733",
            "country_code": "US",
            "telephone_number": "631-288-7746",
            "fax_number": "631-288-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSSIGNAC",
        "first_name": "LUCY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "331017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sag Harbor, NY

Sources for this page

Verify at the official NPI Registry.