NPIMap

Individual provider Active NPI

Carlos Fermo Jr., MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Stony Brook, NY
National Provider Identifier
1326123886
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
233776 Issued in NY
Practice address
100 Patriots Rd
Stony Brook, NY 11790-3318
Phone
(631) 444-8608
NPI assigned
Oct 25, 2006
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 233776 NY Primary

Addresses

Primary practice location

100 Patriots Rd
Stony Brook, NY 11790-3318

Mailing address

100 Patriots Rd
Stony Brook, NY 11790-3318
Phone (631) 444-8608

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
I20050304000244 NY Practitioner - Internal MedicinePractitioner - Infectious DiseasePractitioner - Geriatric Medicine 9739132010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

100 Patriots Rd
Stony Brook, NY 11790-3318
Phone (631) 444-8630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Current Accepting new patients
Good Shepherd Hospice CurrentSince Jan 16, 2025 Accepting new patients
St Catherine of Siena Medical Center Past Accepting new patients

Locations

110 Bi County Blvd
Ste 114
Farmingdale, NY 11735
Phone (631) 465-6300

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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 8

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1326123886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PATRIOTS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903318",
            "telephone_number": "631-444-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PATRIOTS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903318",
            "telephone_number": "631-444-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERMO",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "233776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.