NPIMap

Individual provider Active NPI

Joanne M. Kechejian, M.D.

  • Internal Medicine Physician
  • Nesconset, NY
National Provider Identifier
1316957707
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
197006-1 Issued in NY
Practice address
59 Southern Blvd
Nesconset, NY 11767-1090
Phone
(631) 659-1700
Fax
(631) 659-1750
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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 197006-1 NY Primary

Addresses

Primary practice location

59 Southern Blvd
Nesconset, NY 11767-1090

Mailing address

59 Southern Blvd
Nesconset, NY 11767-1090
Phone (631) 659-1700

Other identifiers 1

IdentifierTypeStateIssuer
45J671OtherNYBLUE CROSS/ BLUE SHIELD

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
I20090721000603 NY Practitioner - Internal Medicine 6608928700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

59 Southern Blvd
Nesconset, NY 11767-1090
Phone (631) 659-1700

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Tender Loving Care, an Amedisys Company Home health agency, Medford, NY, CCN 337260
  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • Centerwell Home Health Home health agency, Hauppauge, NY, CCN 337232
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • 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
197006-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients

Locations

19 E Main St
Ste 2
Bay Shore, NY 11706
Phone (631) 665-6393

66 Commack Rd
Ste 103
Commack, NY 11725
Phone (631) 659-1620

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

59 Southern Blvd
Nesconset, NY 11767
Phone (631) 628-5000

Networks

  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1316957707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671090",
            "telephone_number": "631-659-1700",
            "fax_number": "631-659-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671090",
            "telephone_number": "631-659-1700",
            "fax_number": "631-659-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECHEJIAN",
        "first_name": "JOANNE",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "197006-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "45J671",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.