Individual provider Active NPI

Noelle Mann, M.D.

  • Cardiovascular Disease Physician
  • Commack, NY
National Provider Identifier
1174548333
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
203397 Issued in NY
Practice address
500 Commack Rd Ste 203
Commack, NY 11725-5020
Phone
(631) 444-9600
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 203397 NY Primary

Addresses

Primary practice location

500 Commack Rd Ste 203
Commack, NY 11725-5020

Mailing address

P.O. Box 1559
Stony Brook, NY 11790
Phone (631) 444-9600

Other practice location 1

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Other identifiers 3

IdentifierTypeStateIssuer
02148438MedicaidNY
7743224OtherNYAETNA
16S381OtherNYEMPIRE BC.BS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address noelle.mann@direct.stonybrookmedicine.edu

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000643 NY Practitioner - Cardiovascular Disease (Cardiology) 4486780772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Icahn School of Medicine at Mount Sinai, 1995
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) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 941-2000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203397NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Cardiovascular Disease CurrentSince Mar 31, 1988 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

3001 Express Dr N
Islandia, NY 11749
Phone (631) 292-6747

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

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

Organizations & group practices 3

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 7

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1174548333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-444-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COMMACK RD STE 203",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255020",
            "telephone_number": "631-444-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Research Way",
            "address_purpose": "LOCATION",
            "city": "East Setauket",
            "state": "NY",
            "postal_code": "117333526",
            "country_code": "US",
            "telephone_number": "631-444-0580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "203397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02148438",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7743224",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "16S381",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "noelle.mann@direct.stonybrookmedicine.edu",
            "affiliation": "N",
            "address_1": "500 Commack Rd Ste 203",
            "city": "Commack",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117255020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.