Individual provider Active NPI

Joe Verghese, M.D.

  • Neurology Physician
  • Lake Grove, NY
National Provider Identifier
1235214545
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
232009 Issued in NY
Practice address
Neurology Associates of Stony Brook
4 Smith Haven Mall Suite 105
Lake Grove, NY 11755
Phone
(631) 444-2599
Fax
(631) 392-7213
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 232009 NY Primary

Addresses

Primary practice location

Neurology Associates of Stony Brook
4 Smith Haven Mall Suite 105
Lake Grove, NY 11755

Mailing address

10 Bell Circle Road
Port Jefferson, NY 11777
Phone (631) 444-8118

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
I20080118000270 NY Practitioner - Neurology 8325129042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232009NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Neurology CurrentSince Oct 25, 2024 Accepting new patients
Montefiore Medical Center Neurology CurrentSince Jan 1, 2006 Accepting new patients
Montefiore Medical Center CurrentSince Jan 1, 2006 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1515 Blondell Ave
Ste 220
Bronx, NY 10461
Phone (718) 405-8140

4 Smith Haven Mall
Ste 105
Lake Grove, NY 11755

Church St Sta
New York, NY 10261
Phone (718) 920-4707

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

Networks

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

Organizations & group practices 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1235214545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BELL CIRCLE ROAD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11777",
            "telephone_number": "631-444-8118",
            "fax_number": "631-392-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEUROLOGY ASSOCIATES OF STONY BROOK",
            "address_2": "4 SMITH HAVEN MALL SUITE 105",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "11755",
            "telephone_number": "631-444-2599",
            "fax_number": "631-392-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGHESE",
        "first_name": "JOE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "232009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.