Active NPI
Diana Avsker
- Trauma Surgery Physician
- Stony Brook, NY
National Provider Identifier
1114372893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- 319399-01
- Practice address
- 101 Nicolls Rd
Stony Brook, NY 11794-0001 - Phone
- (631) 444-8329
- NPI assigned
- Apr 29, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Trauma Surgery Physician | 2086S0127X | 319399-01 | NY | Primary |
Addresses
Primary practice location
101 Nicolls Rd
Stony Brook, NY 11794-0001
Mailing address
101 Nicolls Rd # T18-040
Stony Brook, NY 11794-8191
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 319339 | Other | NY | NEW YORK STATE LICENSE |
| LL2803 | Other | NEVADA STATE LICENSE |
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
- General Surgery
- Education
- New York Medical College, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 319399-01 | NY | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Surgical Associates, University Faculty Practice Corporati | Current | Accepting new patients | |
| University Hospital at Stony Brook | Past | Accepting new patients |
Locations
37 Research Way
Ste 200
East Setauket, NY 11733
4 Smith Haven Mall
Ste 200
Lake Grove, NY 11755
Phone (631) 444-4121
37 Research Way
Setauket, NY 11733
Phone (631) 444-4121
101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065
101 Nicolls Rd
#T18040
Stony Brook, NY 11794
Phone (631) 444-8329
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
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.
-
- Surgery Physician
- Stony Brook, NY
- NPI 1063468536
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- 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": "1461888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1114372893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 NICOLLS RD # T18-040",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117948191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 NICOLLS RD",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-444-8329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVSKER",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-29",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "NY",
"license": "319399-01",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE LICENSE",
"identifier": "319339",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEVADA STATE LICENSE",
"identifier": "LL2803",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.