Individual provider Active NPI

Hebbalmath M Thippeswamy, MD

  • Nephrology Physician
  • Shirley, NY
National Provider Identifier
1285683771
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
125473 Issued in NY
Practice address
2 Coraci Blvd
Suite # 9
Shirley, NY 11967-4833
Phone
(631) 281-4861
Fax
(631) 281-8546
NPI assigned
May 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 125473 NY Primary

Addresses

Primary practice location

2 Coraci Blvd
Suite # 9
Shirley, NY 11967-4833

Mailing address

2 Coraci Blvd
Suite # 9
Shirley, NY 11967-4833
Phone (631) 281-4861

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
I20060404000211 NY Practitioner - Internal MedicinePractitioner - Nephrology 7810905767 Reassigns benefits to 1 organization
Practice locations: Shirley, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Coraci Blvd
Shirley, NY 11967-4833
Phone (631) 281-4861

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125473NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NK Medical PC Nephrology CurrentSince Jun 23, 2023 Accepting new patients
Atul N. Shah, MD, PC PastSince Jan 29, 2008 Accepting new patients

Locations

286 Patchogue Yaphank Rd
East Patchogue, NY 11772
Phone (516) 395-9793

129 Main St
Unit 1625
Stony Brook, NY 11790

Interoperability endpoints

  • Direct secure messaging: hthippeswamy504632@nyumc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285683771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "address_2": "SUITE # 9",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-4861",
            "fax_number": "631-281-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "address_2": "SUITE # 9",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-4861",
            "fax_number": "631-281-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIPPESWAMY",
        "first_name": "HEBBALMATH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "125473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.