Individual provider Active NPI

Antonia Tharian, M.D

  • Internal Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1336444595
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
263153 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-4870
Phone
(631) 444-8478
NPI assigned
Jan 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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 263153 NY Primary

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-4870

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-8478

Other names 1

  • Antonia Thomas Kurisinkal Former name

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
I20111214000281 NY Practitioner - HospitalistPractitioner - Internal Medicine 3779758180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

Hospital & facility affiliations

  • 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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Medical Care PC Internal Medicine CurrentSince Apr 1, 2015 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jul 1, 2020 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

101 Hospital Rd
Rm 263
Patchogue, NY 11772
Phone (631) 687-4131

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: antonia.tharian@direct.stonybrookmedicine.edu

Organizations & group practices 4

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 6

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": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1336444595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117944870",
            "telephone_number": "631-444-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARIAN",
        "first_name": "ANTONIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-20",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "263153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONIA",
            "last_name": "KURISINKAL",
            "middle_name": "THOMAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.