Individual provider Active NPI

David A Mayer, MD

  • Surgery Physician
  • Hauppauge, NY
National Provider Identifier
1265471007
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
124152-01 Issued in NY
Practice address
1324 Motor Pkwy Ste 101
Hauppauge, NY 11749-5226
Phone
(631) 255-3304
Fax
(631) 364-9672
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 124152 NY
Surgery Physician 208600000X 124152-01 NY Primary

Addresses

Primary practice location

1324 Motor Pkwy Ste 101
Hauppauge, NY 11749-5226

Mailing address

223 Wall St Ste 190
Huntington, NY 11743-2060
Phone (631) 255-3304

Other identifiers 1

IdentifierTypeStateIssuer
00315673MedicaidNY

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
I20090625000444 NY Practitioner - General SurgeryPractitioner - Vascular Surgery 6002967452 Practice locations: Port Jefferson, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124152-01NYMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: dmayer91871@direct-chsli.net

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1265471007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 WALL ST STE 190",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432060",
            "telephone_number": "631-255-3304",
            "fax_number": "631-364-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 MOTOR PKWY STE 101",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117495226",
            "telephone_number": "631-255-3304",
            "fax_number": "631-364-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "124152",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "124152-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00315673",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.