Individual provider Active NPI

Rosemarie Anne Montecalvo, DO

  • Child & Adolescent Psychiatry Physician
  • Stony Brook, NY
National Provider Identifier
1235692559
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
325721 Issued in NY
Practice address
Putnam Hall
Stony Brook, NY 11794-0001
Phone
(631) 632-2428
NPI assigned
Apr 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 325721 NY
Child & Adolescent Psychiatry Physician 2084P0804X 325721 NY Primary

Addresses

Primary practice location

Putnam Hall
Stony Brook, NY 11794-0001

Mailing address

Health Sciences Center T10-020
Stony Brook, NY 11794-0001

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
I20240314002627 NY Practitioner - Psychiatry 7618313453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

169 Putnam Hall
South Campus
Stony Brook, NY 11794-8790
Phone (631) 632-8850

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325721NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John T. Mather Memorial Hospital Psychiatry Current Accepting new patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Psychiatry CurrentSince Feb 19, 2024 Accepting new patients
John T. Mather Memorial Hospital Psychiatry CurrentSince Apr 11, 2024 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Apr 11, 2024 Accepting new patients

Locations

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

125 Oakland Ave
Ste 303
Port Jefferson, NY 11777
Phone (631) 729-2140

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1235692559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HEALTH SCIENCES CENTER T10-020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PUTNAM HALL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-632-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTECALVO",
        "first_name": "ROSEMARIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325721",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "325721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.