Individual provider Active NPI

Vasilios Kalonaros, M.D.

  • Internal Medicine Physician
  • Smithtown, NY
National Provider Identifier
1376501296
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
183593 Issued in NY
Practice address
50 Karl Ave Ste 301
Smithtown, NY 11787-2744
Phone
(631) 239-1677
Fax
(631) 724-3967
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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 183593 NY Primary

Addresses

Primary practice location

50 Karl Ave Ste 301
Smithtown, NY 11787-2744

Mailing address

50 Karl Ave Ste 301
Smithtown, NY 11787-2744
Phone (631) 239-1677

Other identifiers 2

IdentifierTypeStateIssuer
W34601OtherNYGROUP UPIN
01201490MedicaidNY

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
I20110719000081 NY Practitioner - Internal Medicine 4385812486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1019 Fort Salonga Rd
Suite 101
Northport, NY 11768-2270
Phone (631) 262-1314

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • 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
183593NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Suffolk Medical Associates, P.C. CurrentSince Oct 1, 1999 Accepting new patients

Locations

1019 Fort Salonga Rd
Ste 101
Northport, NY 11768
Phone (516) 262-1314

50 Karl Ave
Ste 301
Smithtown, NY 11787
Phone (631) 239-1677

Interoperability endpoints

  • Direct secure messaging: vasilios.kalonaros.1@13301.direct.athenahealth.com

Organizations & group practices 1

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 7

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1376501296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KARL AVE STE 301",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872744",
            "telephone_number": "631-239-1677",
            "fax_number": "631-724-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KARL AVE STE 301",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872744",
            "telephone_number": "631-239-1677",
            "fax_number": "631-724-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALONAROS",
        "first_name": "VASILIOS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "183593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP UPIN",
            "identifier": "W34601",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01201490",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.