Individual provider Active NPI

Bellamy Brook, D.O. P.C.

  • Family Medicine Physician
  • Riverhead, NY
National Provider Identifier
1477511749
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
215053-1 Issued in NY
Practice address
300 Old Country Rd Ste 2
Riverhead, NY 11901-2146
Phone
(631) 405-5544
Fax
(800) 627-1462
NPI assigned
May 3, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 215053-1 NY Primary

Addresses

Primary practice location

300 Old Country Rd Ste 2
Riverhead, NY 11901-2146

Mailing address

300 Old Country Rd Ste 2
Riverhead, NY 11901-2146
Phone (631) 405-5544

Other practice location 1

6144 Route 25A Ste 14
Wading River, NY 11792-2008
Phone (631) 405-5544

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
I20041216001032 NY Practitioner - Family Practice 2163489535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Old Country Rd
Riverhead, NY 11901-2146
Phone (631) 405-5544

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215053-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Family Medicine CurrentSince Apr 2, 2018 Accepting new patients
Vytaliz Medical CurrentSince May 17, 2022 Accepting new patients
Dr. Judith Magloczki, D.O., P.C. Family Medicine CurrentSince May 8, 2022 Accepting new patients
Island Urgent Medical Care, P.C. Family Medicine Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

300 Community Dr
Manhasset, NY 11030

3 E Evergreen Rd
Ste 1017
New City, NY 10956
Phone (201) 565-2533

1272 E Main St
Riverhead, NY 11901
Phone (631) 284-3793

300 Old Country Rd
Ste 2
Riverhead, NY 11901
Phone (631) 405-5544

6144 Route 25A
Ste 14
Wading River, NY 11792
Phone (631) 405-5544

6144 Route 25A
Ste 19
Wading River, NY 11792
Phone (631) 751-0000

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: bbrook65426@northwell.direct-ci.com
  • Direct secure messaging: bellamybrook@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIACCD/Endpoint/HIACCD

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

Hospital & facility affiliations 3

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477511749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD STE 2",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012146",
            "telephone_number": "631-405-5544",
            "fax_number": "800-627-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD STE 2",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012146",
            "telephone_number": "631-405-5544",
            "fax_number": "800-627-1462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6144 Route 25A Ste 14",
            "address_purpose": "LOCATION",
            "city": "Wading River",
            "state": "NY",
            "postal_code": "117922008",
            "country_code": "US",
            "telephone_number": "631-405-5544",
            "fax_number": "800-627-1462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOK",
        "first_name": "BELLAMY",
        "name_prefix": "Dr.",
        "credential": "D.O. P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "215053-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.