Anna Adam, MD
Individual provider Active NPI Internal Medicine Physician · Stony Brook, NY
NPI 1306266705 · NPPES record last updated Aug 6, 2020
Key facts
- NPI
- 1306266705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 289943-1 (NY)
- Practice address
- 100 Nicolls Rd
Stony Brook, NY 11794-2153 - Phone
- (631) 444-8478
- NPI assigned
- Apr 24, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stony Brook Internists University Faculty Practice Corporation
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560
Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170926000316 | NY | Practitioner - Hospitalist | 5597039859 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 289943-1 | NY | MD | Internal Medicine Physician |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Current |
Accepting new patients |
| University Hospital at Stony Brook | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Current |
Accepting new patients | |
| University Physician Group | Past | Accepting new patients |
Locations
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
100 Nicolls Rd
#13202
Stony Brook, NY 11794
100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- anna.adam@direct.stonybrookmedicine.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301114100 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 289943-1 | NY | Yes |
Addresses
Primary practice location
100 Nicolls Rd
Stony Brook, NY 11794-2153
Mailing address
PO Box 1559
Stony Brook, NY 11790-0989
Other providers in Stony Brook, NY
- Susan Hannah Abramovich
- Marsha Lynne Abrams
- Ahmad Abulseoud
- Akif Acay Sr.
- Lisa Accardi
- Adeola Adeyeye
- Rishimani Adsumelli
- Advanced Dermatology PC
- Advanced Endodontics of Long Island, P.C.
- Sean Jason Adwar
All providers in Stony Brook, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.