Individual provider Active NPI

Theresa Marie Vlahos, N.P.

  • Pediatric Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1184845661
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F381179-1 Issued in NY
Practice address
Stonybrook University Medical Ctr
Suny - 9440
Stony Brook, NY 11794-9440
Phone
(631) 444-9267
Fax
(631) 444-1211
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300544-1 NY
Pediatric Nurse Practitioner 363LP0200X F381179-1 NY Primary

Addresses

Primary practice location

Stonybrook University Medical Ctr
Suny - 9440
Stony Brook, NY 11794-9440

Mailing address

58 Hilden St
Kings Park, NY 11754-1768
Phone (631) 444-9267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F300544-1NYMDAdult Health Nurse Practitioner
F381179-1NYMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1184845661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 HILDEN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541768",
            "telephone_number": "631-444-9267",
            "fax_number": "631-444-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONYBROOK UNIVERSITY MEDICAL CTR",
            "address_2": "SUNY - 9440",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117949440",
            "telephone_number": "631-444-9267",
            "fax_number": "631-444-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLAHOS",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300544-1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381179-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.