NPIMap

Individual provider Active NPI

Anton Oscar Beitia, MD

  • Neuroradiology Physician
  • Stony Brook, NY
National Provider Identifier
1467530386
Registry record updated Jan 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
189541-1 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-8460
Phone
(631) 444-5400
NPI assigned
Nov 1, 2006
Last updated
Jan 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 57519 MN
Diagnostic Radiology Physician 2085R0202X 189541-1 NY
Diagnostic Ultrasound Physician 2085U0001X 189541-1 NY
Neuroradiology Physician 2085N0700X 189541-1 NY Primary
Neuroradiology Physician 2085N0700X 189541 NY
Nuclear Radiology Physician 2085N0904X 189541-1 NY

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-8460

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-5400

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 1

IdentifierTypeStateIssuer
01886355MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000016 NY Practitioner - Diagnostic Radiology 0446153902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
189541NYMDNeuroradiology Physician
189541-1NYMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients
Lucia's Pharmacy Inc. CurrentSince Nov 1, 2019 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Comprehensive MRI of New York, P.C. Diagnostic Radiology Past Accepting new patients
University Medical Imaging PC Diagnostic Radiology Past Accepting new patients
CHS Physician Partners, P.C Past Accepting new patients

Locations

2090 Hylan Blvd
Staten Island, NY 10306
Phone (718) 351-0616

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

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

Interoperability endpoints

  • Direct secure messaging: anton.beitia@direct.stonybrookmedicine.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1467530386",
    "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": "631-444-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-444-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEITIA",
        "first_name": "ANTON",
        "middle_name": "OSCAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "57519",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "189541-1",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NY",
            "license": "189541-1",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "189541-1",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "189541",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NY",
            "license": "189541-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01886355",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.