Individual provider Active NPI

Tintu Chiramel, D.O.

  • Internal Medicine Physician
  • Smithtown, NY
National Provider Identifier
1275878027
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
274958-1 Issued in NY
Practice address
309 E Main St
Smithtown, NY 11787-2844
Phone
(631) 656-6360
NPI assigned
Dec 5, 2012
Last updated
Jun 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 274958-1 NY Primary

Addresses

Primary practice location

309 E Main St
Smithtown, NY 11787-2844

Mailing address

45 Research Way
East Setauket, NY 11733-6401
Phone (631) 675-2125

Other practice location 1

1766 Sunrise Hwy
Bay Shore, NY 11706-6042
Phone (631) 656-9040

Other identifiers 1

IdentifierTypeStateIssuer
3950974MedicaidNY

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
I20140731001357 NY Practitioner - Internal Medicine 2062638844 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Nova Southeastern Univ College of Dental Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274958-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Jul 21, 2014 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

575 Underhill Blvd
Ste 130
Syosset, NY 11791
Phone (516) 294-9540

575 Underhill Blvd
Ste 190
Syosset, NY 11791
Phone (516) 210-8840

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: tchiramel18457@direct.optum.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1275878027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872844",
            "telephone_number": "631-656-6360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1766 Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117066042",
            "country_code": "US",
            "telephone_number": "631-656-9040",
            "fax_number": "631-968-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIRAMEL",
        "first_name": "TINTU",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-05",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "274958-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3950974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.