Individual provider Active NPI

Timothy Richard Dackow, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • East Moriches, NY
National Provider Identifier
1144700741
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F3088261 Issued in NY
Practice address
7 Newpoint LN
East Moriches, NY 11940-1565
Phone
(516) 322-8850
NPI assigned
Aug 14, 2018
Last updated
Aug 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F3088261 NY Primary

Addresses

Primary practice location

7 Newpoint LN
East Moriches, NY 11940-1565

Mailing address

7 Newpoint LN
East Moriches, NY 11940-1565
Phone (516) 322-8850

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
I20180920002132 NY Practitioner - Nurse Practitioner 6406107002 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stony Brook Internists University Faculty Practice CorporationGroup PAC ID 9133019821, shared by 4 NPIs, 427 clinicians

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001

101 Nicolls Rd
Stony Brook, NY 11794-0001

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3088261NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Critical Care, LLP CurrentSince Jan 10, 2022 Accepting new patients
North Shore-Lij Medical PC CurrentSince Apr 2, 2020 Accepting new patients
New York University CurrentSince Nov 6, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Nov 29, 2025 Accepting new patients
Stony Brook Emergency Physicians, University Faculty Practice Corporat CurrentSince Sep 1, 2025 Accepting new patients
New York University CurrentSince Nov 6, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Mar 31, 2025 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. Current Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince Feb 16, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Apr 2, 2020 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Mar 31, 2025 Accepting new patients
Long Island Community Hospital at NYU Langone Health CurrentSince Feb 16, 2019 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1001 Franklin Ave
Garden City, NY 11530
Phone (516) 240-8700

300 Community Dr
Manhasset, NY 11030

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

951 Roanoke Ave
Riverhead, NY 11901
Phone (631) 369-5005

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: tdackow501378@nyumc.direct-ci.com

Organizations & group practices 12

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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1144700741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 NEWPOINT LN",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401565",
            "telephone_number": "516-322-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 NEWPOINT LN",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401565",
            "telephone_number": "516-322-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACKOW",
        "first_name": "TIMOTHY",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F3088261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Moriches, NY

Sources for this page

Verify at the official NPI Registry.