NPIMap

Individual provider Active NPI

Keaira C Dupuy, MD

  • Family Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1164915484
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
311872 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-2324
Phone
(631) 963-6795
Fax
(631) 471-1000
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 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 311872 NY Primary

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-2324

Mailing address

48 Skyline Dr
Coram, NY 11727-3630
Phone (631) 942-5929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722002335 NY Practitioner - HospitalistPractitioner - Family Practice 1355744756 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Northeastern Ohio University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

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

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311872NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince May 1, 2024 Accepting new patients
Advantagecare Physicians PC CurrentSince Nov 28, 2022 Accepting new patients
Advantagecare Physicians PC Family Medicine CurrentSince Nov 28, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince May 1, 2024 Accepting new patients
Sun River Health Inc. CurrentSince Jul 14, 2021 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

55 Water St
Fl 2
New York, NY 10041

640 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 737-0100

330 Meeting House Ln
Southampton, NY 11968
Phone (631) 268-1008

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

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

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 6

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.

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1164915484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SKYLINE DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117273630",
            "telephone_number": "631-942-5929",
            "fax_number": "516-542-5556"
        },
        {
            "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": "117942324",
            "telephone_number": "631-963-6795",
            "fax_number": "631-471-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPUY",
        "first_name": "KEAIRA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "311872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.