Individual provider Active NPI

Nick N Patel, D.O.

  • Pulmonary Disease Physician
  • Port Jefferson, NY
National Provider Identifier
1457536377
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
246771 Issued in NY
Practice address
70 N Country Rd Ste 101
Port Jefferson, NY 11777-2161
Phone
(631) 473-0037
Fax
(631) 473-0228
NPI assigned
Jan 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 246771 NY
Pulmonary Disease Physician 207RP1001X 246771 NY Primary

Addresses

Primary practice location

70 N Country Rd Ste 101
Port Jefferson, NY 11777-2161

Mailing address

45 Research Way Ste 105
East Setauket, NY 11733-6401
Phone (631) 675-2624

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address npatel@nsc.direct.gemmsnest.com Direct

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
I20080703000416 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Undersea and Hyperbaric Medicine 3375615594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Undersea and Hyperbaric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

1300 Roanoke Ave
Riverhead, NY 11901-2031
Phone (631) 548-6000

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

Hospital & facility affiliations

  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Pulmonary Disease CurrentSince May 14, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince May 14, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients
Stony Brook Gynecology & Obstetrics, P.C. Past Accepting new patients

Locations

200 Motor Pkwy
Hauppauge, NY 11788
Phone (631) 234-5666

1500 Route 112
Ste B
Port Jefferson Station, NY 11776
Phone (631) 343-4184

75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

47 Commerce Ave
Ste 1
Riverhead, NY 11901
Phone (631) 978-7633

100 Nicolls Rd
#13202
Stony Brook, NY 11794

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: npatel65931@northwell.direct-ci.com
  • Direct secure messaging: nick.patel@sbcm.cernerdirect.com

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 9

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1457536377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 105",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-675-2624",
            "fax_number": "631-675-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD STE 101",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-473-0037",
            "fax_number": "631-473-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NICK",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "246771",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "246771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npatel@nsc.direct.gemmsnest.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "70 N Country Rd Ste 101",
            "city": "Port Jefferson",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117772161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.