Individual provider Active NPI

Meredith T Vandegrift, MD

  • Plastic Surgery Physician
  • Huntington, NY
National Provider Identifier
1417118597
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
252484 Issued in NY
Practice address
100 E Main St
Huntington, NY 11743-2847
Phone
(631) 935-0303
Fax
(631) 424-4027
NPI assigned
Jun 20, 2008
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 69728 GA
Plastic Surgery Physician 208200000X 252484 NY Primary

Addresses

Primary practice location

100 E Main St
Huntington, NY 11743-2847

Mailing address

100 E Main St
Huntington, NY 11743-2847
Phone (631) 935-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190121000083 NY Practitioner - Plastic and Reconstructive Surgery 3173759164 Reassigns benefits to 1 organization
Practice locations: Huntington, NY

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
State University of New York at Stony Brook, School of Medicine, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

864 W Jericho Tpke
Huntington, NY 11743-6064

864 W Jericho Turnpike
Huntington, NY 11743

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69728GAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith Vandegrift, MD, PC Plastic Surgery CurrentSince Jun 7, 2022 Accepting new patients

Locations

100 E Main St
Huntington, NY 11743
Phone (631) 424-4004

864 W Jericho Tpke
Huntington, NY 11743
Phone (631) 423-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1417118597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432847",
            "telephone_number": "631-935-0303",
            "fax_number": "631-424-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432847",
            "telephone_number": "631-935-0303",
            "fax_number": "631-424-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEGRIFT",
        "first_name": "MEREDITH",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "69728",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "252484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.