NPIMap

Individual provider Active NPI

Luis Augusto Marcos Raymundo, M.D.

  • Infectious Disease Physician
  • Stony Brook, NY
National Provider Identifier
1205161015
Registry record updated Jul 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
21387 Issued in MS
Practice address
HSC T15 080
Stony Brook, NY 11794-8153
Phone
(631) 444-3490
Fax
(631) 638-7518
NPI assigned
Oct 12, 2009
Last updated
Jul 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Infectious Disease Physician 207RI0200X 21387 MS Primary

Addresses

Primary practice location

HSC T15 080
Stony Brook, NY 11794-8153

Mailing address

PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-0650

Other identifiers 5

IdentifierTypeStateIssuer
06575513OtherMSMAGNOLIA
06575513MedicaidMS
9576702OtherMSAETNA
3310476OtherUHC
302I449980OtherMSMEDICARE PTAN

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
I20150814012987 NY Practitioner - Infectious Disease 2567640634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

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

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

PO Box
Suite 1554
Stony Brook, NY 11790-0989

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Feb 5, 2017 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Infectious Disease Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Feb 5, 2017 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

205 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 444-1660

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

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: luis.marcosraymundo@direct.stonybrookmedicine.edu

Organizations & group practices 4

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.

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": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436054400000",
    "number": "1205161015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-0650",
            "fax_number": "631-638-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC T15 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948153",
            "telephone_number": "631-444-3490",
            "fax_number": "631-638-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOS RAYMUNDO",
        "first_name": "LUIS",
        "middle_name": "AUGUSTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-12",
        "last_updated": "2015-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "21387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGNOLIA",
            "identifier": "06575513",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06575513",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9576702",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3310476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I449980",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.