Individual provider Active NPI

Harriet Stathakos, M.D.

  • Internal Medicine Physician
  • Syosset, NY
National Provider Identifier
1184023350
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
193507 Issued in NY
Practice address
331 Southwood Cir
Syosset, NY 11791-5715
Phone
(516) 921-0182
NPI assigned
Aug 14, 2014
Last updated
Aug 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 193507 NY Primary

Addresses

Primary practice location

331 Southwood Cir
Syosset, NY 11791-5715

Mailing address

331 Southwood Cir
Syosset, NY 11791-5715
Phone (516) 921-0182

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
I20250312002850 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0749701274

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193507NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Networks

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1184023350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SOUTHWOOD CIR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915715",
            "telephone_number": "516-921-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SOUTHWOOD CIR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915715",
            "telephone_number": "516-921-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHAKOS",
        "first_name": "HARRIET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "193507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.