Individual provider Active NPI

Katrina D'Amore, D.O.

  • Emergency Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1215313812
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
302516 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-7745
Phone
(631) 689-8333
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 302516 NY Primary

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-7745

Mailing address

101 Nicholls Rd
HSC, L-4, RM 050
Stony Brook, NY 11794

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
I20200505002907 NY Practitioner - Emergency Medicine 7719239052 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coney Island Medical Practice Plan, P.C. CurrentSince Jul 15, 2021 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Mar 1, 2020 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Samaritan Emergency Medical Services, PC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Stony Brook Emergency Physicians, University Faculty Practice Corporat Emergency Medicine CurrentSince Dec 1, 2023 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

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

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1215313812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICHOLLS RD",
            "address_2": "HSC, L-4, RM 050",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947745",
            "telephone_number": "631-689-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMORE",
        "first_name": "KATRINA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2023-11-29",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "302516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.