Individual provider Active NPI

Doreen Panzarella

  • Obstetrics & Gynecology Physician
  • Stony Brook, NY
National Provider Identifier
1407219710
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
302875-01 Issued in NY
Practice address
Stony Brook Medicine Dept of OBGYN, HSC, T9
101 Nichols Road
Stony Brook, NY 11794-8091
Phone
(631) 444-4686
Fax
(631) 444-4622
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 302875-01 NY Primary

Addresses

Primary practice location

Stony Brook Medicine Dept of OBGYN, HSC, T9
101 Nichols Road
Stony Brook, NY 11794-8091

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-4686

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
I20200918000506 NY Practitioner - Obstetrics/Gynecology 3577981851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Drexel University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8091
Phone (631) 444-7650

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302875NYMDLicensed Practical Nurse
302875-01NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Associates in Obstetrics & Gynecology, University Faculty P Obstetrics & Gynecology CurrentSince Jul 6, 2020 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Locations

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: doreenann.panzarella@direct.stonybrookmedicine.edu

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1407219710",
    "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": "631-444-4686",
            "fax_number": "631-444-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK MEDICINE DEPT OF OBGYN, HSC, T9",
            "address_2": "101 NICHOLS ROAD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948091",
            "telephone_number": "631-444-4686",
            "fax_number": "631-444-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANZARELLA",
        "first_name": "DOREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "302875-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.