Active NPI
Dimitri N Kessaris MDPC
- Urology Physician
- Manhasset, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 1944221
- Legal business name
- DIMITRI N KESSARIS MDPC
- Practice address
- 315 East Shore Road
Manhasset, NY 11030 - Phone
- (516) 487-5577
- Fax
- (516) 487-2947
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dimitri N Kessaris, MD
- Title
- President
- Phone
- (516) 487-5577
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 1944221 | NY | Primary |
Addresses
Primary practice location
315 East Shore Road
Manhasset, NY 11030
Mailing address
315 East Shore Road
Manhasset, NY 11030
Phone (516) 487-5577
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04172B | Other | NY | GHI MEDICARE |
| 03794781 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070223000311 | NY | Part B Supplier - Clinic/Group Practice | 5799782587 |
Receives reassigned benefits from 30 practitioners Practice locations: New York, NY; Manhasset, NY; Jackson Heights, NY; Forest Hills, NY; Brooklyn, NY; Elmhurst, NY; Astoria, NY |
National Provider Directory
National Provider DirectoryLocations
618 Route 110
Amityville, NY 11701
Phone (516) 691-6000
3245 Bell Blvd
#1
Bayside, NY 11361
Phone (718) 544-4443
7210 13th Ave
Fl 2
Brooklyn, NY 11228
Phone (718) 439-2388
3505 Farrington St
Fl 2
Flushing, NY 11354
Phone (718) 544-4443
10614 70th Ave
Forest Hills, NY 11375
Phone (718) 520-6620
415 Northern Blvd
Great Neck, NY 11021
Phone (201) 684-1633
Practitioners & affiliated clinicians
Practitioners 32
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Uniondale, NY
- NPI 1740312818
NY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665705600000",
"number": "1154430148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 EAST SHORE ROAD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "11030",
"telephone_number": "516-487-5577",
"fax_number": "516-487-2947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 EAST SHORE ROAD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "11030",
"telephone_number": "516-487-5577",
"fax_number": "516-487-2947"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIMITRI N KESSARIS MDPC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-30",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A",
"authorized_official_last_name": "KESSARIS",
"authorized_official_first_name": "DIMITRI",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "516-487-5577",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "NY",
"license": "1944221",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI MEDICARE",
"identifier": "04172B",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03794781",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.