Individual provider Active NPI

Asha Lata Patnaik, MD

  • Rheumatology Physician
  • East Setauket, NY
National Provider Identifier
1386742419
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
263442 Issued in NY
Practice address
26 Research Way
East Setauket, NY 11733
Phone
(631) 444-0580
Fax
(631) 444-0562
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5898 SD
Internal Medicine Physician 207R00000X 35-090755 OH
Hospitalist Physician 208M00000X 35.090755 OH
Rheumatology Physician 207RR0500X 263442 NY Primary

Addresses

Primary practice location

26 Research Way
East Setauket, NY 11733

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
6005490MedicaidSD
35-090755OtherOHLICENSE
5898OtherSDLICENSE

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
I20120723000116 NY Practitioner - Rheumatology 2466450929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Hematology
Stonybrook, NY 11794-0001
Phone (631) 444-7643

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

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-090755OHMDInternal Medicine Physician
263442NYMDRheumatology Physician
35.090755OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Rheumatology CurrentSince Jul 1, 2012 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jul 1, 2012 Accepting new patients
Inpatient Medical Services, Inc. Internal Medicine Past Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

500 Commack Rd
Ste 103
Commack, NY 11725
Phone (631) 638-0160

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

4 Smith Haven Mall
Ste 203
Lake Grove, NY 11755
Phone (631) 444-0561

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: asha.patnaik@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 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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1386742419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 RESEARCH WAY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333526",
            "telephone_number": "631-444-0580",
            "fax_number": "631-444-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 RESEARCH WAY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-444-0580",
            "fax_number": "631-444-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATNAIK",
        "first_name": "ASHA",
        "middle_name": "LATA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "5898",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-090755",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.090755",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "263442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005490",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35-090755",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5898",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.