Individual provider Active NPI

Amar Vyas, DO

  • Sports Medicine (Family Medicine) Physician
  • Shirley, NY
National Provider Identifier
1205323359
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
309430 Issued in NY
Practice address
855 Montauk Hwy Ste a
Shirley, NY 11967-2153
Phone
(631) 369-5000
NPI assigned
Apr 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 309430 NY Primary

Addresses

Primary practice location

855 Montauk Hwy Ste a
Shirley, NY 11967-2153

Mailing address

1300 Roanoke Ave
Riverhead, NY 11901-2031
Phone (631) 639-5000

Other practice location 1

80 E Montauk Hwy Ste 102
Hampton Bays, NY 11946-1878
Phone (631) 369-5000

Other practice location 2

1300 Roanoke Ave
Riverhead, NY 11901-2031
Phone (631) 548-6000

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
I20220819001664 NY Practitioner - Sports MedicinePractitioner - Family Practice 3577817253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peconic Bay Primary Medical CareGroup PAC ID 7113817602, 72 clinicians

Practice addresses (Care Compare)

855 Montauk Hwy
Shirley, NY 11967-2153
Phone (631) 815-1968

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309430NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peconic Bay Primary Medical Care CurrentSince Sep 1, 2022 Accepting new patients
Central Suffolk Hosptial CurrentSince Aug 1, 2022 Accepting new patients
Central Suffolk Hospital CurrentSince Aug 1, 2022 Accepting new patients
Prime Care Medical of Long Island, PC Family Medicine Past Accepting new patients
North Shore-Lij Medical PC Family Medicine PastSince Oct 16, 2022 Accepting new patients

Locations

80 E Montauk Hwy
Ste 102
Hampton Bays, NY 11946
Phone (631) 369-5000

64 Commerce Ave
Riverhead, NY 11901
Phone (631) 369-5000

34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

855 Montauk Hwy
Ste A
Shirley, NY 11967
Phone (631) 369-5000

855 Montauk Hwy
Shirley, NY 11967
Phone (631) 369-4994

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: avyas70464@northwell.direct-ci.com

Organizations & group practices 5

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 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": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1205323359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012031",
            "telephone_number": "631-639-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTAUK HWY STE A",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672153",
            "telephone_number": "631-369-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 E Montauk Hwy Ste 102",
            "address_purpose": "LOCATION",
            "city": "Hampton Bays",
            "state": "NY",
            "postal_code": "119461878",
            "country_code": "US",
            "telephone_number": "631-369-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012031",
            "country_code": "US",
            "telephone_number": "631-548-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VYAS",
        "first_name": "AMAR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-15",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "309430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.