Tania Naticha Alicea, CNM
Individual provider Active NPI Midwife · Stony Brook, NY
NPI 1467700153 · NPPES record last updated Mar 3, 2020
Key facts
- NPI
- 1467700153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- F001951 (NY)
- Practice address
- 101 Nicolls Rd
HSC 9, RM 020
Stony Brook, NY 11794-0001 - Phone
- (631) 444-3987
- NPI assigned
- Aug 28, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Associates in Obstetrics and Gynecology University Faculty
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-8091
Phone (631) 444-7650
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200325001432 | NY | Practitioner - Certified Nurse Midwife (CNM) | 6507294543 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001951 | NY | MD | Mental Health Counselor |
| F001951 | NY | MD | Midwife |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Associates in Obstetrics & Gynecology, University Faculty P | Current |
Accepting new patients | |
| University Hospital at Stony Brook | Current | Accepting new patients | |
| Neurology Associates of Stony Brook, University Faculty Practice Corpo | Current |
Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Past | Accepting new patients |
Locations
500 Commack Rd
Unit 200
Commack, NY 11725
Phone (631) 638-0140
101 Nicolls Rd
Rm 20
Stony Brook, NY 11794
Phone (631) 444-2739
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
- tania.alicea@direct.stonybrookmedicine.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | F001951 | NY | Yes |
Addresses
Primary practice location
101 Nicolls Rd
HSC 9, RM 020
Stony Brook, NY 11794-0001
Mailing address
PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 578-3178
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.