Spiro Theoharakis, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

175445 Issued in NY

Practice address

50 Karl Ave
Ste 205
Smithtown, NY 11787-2744

Phone

(631) 366-3600

Fax

(631) 366-3667

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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.

• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107
  Medicare reassignment NPD
• Skills Unlimited, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oakdale, NY
  • NPI 1487789392
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1124004056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KARL AVE",
            "address_2": "STE 205",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872744",
            "telephone_number": "631-366-3600",
            "fax_number": "631-366-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KARL AVE",
            "address_2": "STE 205",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872744",
            "telephone_number": "631-366-3600",
            "fax_number": "631-366-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOHARAKIS",
        "first_name": "SPIRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "175445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01589399",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Marotta Center, Inc.
• The Pederson Krag Center
• The Wellness Nook
• Theatre Surgical Arts Office Based Surgery, PC
• Alane Joyce Theofield, RN
• Thomas E. Conway, LCSW, P.C.
• Thomas Yarrobino, PT, PC
• Judith Yvette Thomas, ANP-C
• Robert Thompson
• Shelbi A Thurau, RD

• Psychiatry Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.