NPIMap

Individual provider Active NPI

Lesley Anne Bennici, M.D.

  • Anesthesiology Physician
  • Stony Brook, NY
National Provider Identifier
1265799423
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
279323-1 Issued in NY
Practice address
Department of Anesthesiology Stony Brook Medicine
Stony Brook, NY 11794-6402
Phone
(631) 444-2975
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 279323 NY
Anesthesiology Physician 207L00000X 279323-1 NY Primary

Addresses

Primary practice location

Department of Anesthesiology Stony Brook Medicine
Stony Brook, NY 11794-6402

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989

Other practice location 1

550 1st Ave
NYU Langone Medical Center
New York, NY 10016-6402
Phone (212) 263-5506

Other names 1

  • Lesley Anne Russell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613001747 NY Practitioner - Anesthesiology 0749570232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8480
Phone (631) 444-2975

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794-0001
Phone (631) 638-0800

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279323-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Anesthesiology CurrentSince Jun 4, 2018 Accepting new patients
New York University Anesthesiology Current Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
New York University CurrentSince Jul 1, 2016 Accepting new patients
New York University Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

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

Interoperability endpoints

  • Direct secure messaging: lesley.bennici@direct.stonybrookmedicine.edu

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.

Hospital & facility affiliations 6

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1265799423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF ANESTHESIOLOGY STONY BROOK MEDICINE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117946402",
            "telephone_number": "631-444-2975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_2": "NYU Langone Medical Center",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNICI",
        "first_name": "LESLEY",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "279323",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "279323-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLEY",
            "last_name": "RUSSELL",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.