NPIMap

Individual provider Active NPI

Peter Gregg Michaelson, M.D.

  • Otolaryngology Physician
  • Nesconset, NY
National Provider Identifier
1447367370
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
334418 Issued in NY
Practice address
59 Southern Blvd
Nesconset, NY 11767-1090
Phone
(934) 213-5000
Fax
(631) 892-3513
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 334418 NY Primary

Addresses

Primary practice location

59 Southern Blvd
Nesconset, NY 11767-1090

Mailing address

59 Southern Blvd
Nesconset, NY 11767-1090
Phone (934) 213-5000

Other identifiers 1

IdentifierTypeStateIssuer
2720158MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070319000040 OH Practitioner - Otolaryngology 4486757150 Reassigns benefits to 1 organization
I20250724000064 NY Practitioner - OtolaryngologyPractitioner - General Surgery 4486757150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: General Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
87.12 of 100Reported as group
Quality
84.25
Promoting interoperability
100
Improvement activities
40
Cost
72.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
334418NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uvpc Specialists Inc. CurrentSince Dec 26, 2022 Accepting new patients
Ohio Valley Medical Center, LLC Current Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Jul 15, 2025 Accepting new patients
Uvpc Specialists, Inc. CurrentSince Dec 26, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

59 Southern Blvd
Nesconset, NY 11767
Phone (631) 628-5000

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

30 E Apple St
Ste 6252
Dayton, OH 45409
Phone (937) 208-6060

8439 Yankee St
Dayton, OH 45458
Phone (937) 440-7872

1055 Summit Dr
Middletown, OH 45042
Phone (513) 420-4678

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

3130 N County Road 25A
Ste 212
Troy, OH 45373
Phone (937) 335-0061

31 S Stanfield Rd
Ste 304
Troy, OH 45373
Phone (937) 339-1518

Networks

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

Interoperability endpoints

  • Direct secure messaging: pmichaelso@direct.ovsurgical.com

Organizations & group practices 5

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1447367370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671090",
            "telephone_number": "934-213-5000",
            "fax_number": "631-892-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671090",
            "telephone_number": "934-213-5000",
            "fax_number": "631-892-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELSON",
        "first_name": "PETER",
        "middle_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "334418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2720158",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.