Individual provider Active NPI

Alexander B Dagum, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Garden City, NY
National Provider Identifier
1487673091
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
230546 Issued in NY
Practice address
999 Franklin Ave
Garden City, NY 11530-2913
Phone
(631) 742-3404
Fax
(516) 742-4716
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 230546 NY Primary

Addresses

Primary practice location

999 Franklin Ave
Garden City, NY 11530-2913

Mailing address

P.O. Box 1559
Stony Brook, NY 11790

Other identifiers 3

IdentifierTypeStateIssuer
7863214OtherNYAETNA
02112870MedicaidNY
43L481OtherNYEMPIRE BC.BS

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
I20040202000364 NY Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 2264335660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Plastic Surgical Group, PCGroup PAC ID 1153340054, 39 clinicians

Practice addresses (Care Compare)

999 Franklin Ave
Suite 300
Garden City, NY 11530-2913
Phone (516) 629-3838

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • Nassau University Medical Center Hospital, East Meadow, NY, CCN 330027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision77
Removal of tissue12
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Plastic Surgical Group, PC CurrentSince Aug 12, 2024 Accepting new patients
Stony Brook Orthopaedic Associates, University Faculty Practice Corpor PastSince Jan 21, 2011 Accepting new patients

Locations

999 Franklin Ave
Ste 300
Garden City, NY 11530
Phone (516) 535-6778

999 Franklin Ave
Garden City, NY 11530
Phone (516) 742-3404

5316 Nesconset Hwy
Port Jefferson Station, NY 11776
Phone (631) 689-7800

Networks

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

Interoperability endpoints

  • Direct secure messaging: adagum@directaddress.net
  • Direct secure messaging: alexander.dagum@direct.stonybrookmedicine.edu
  • Direct secure messaging: adagum651403@nyumc.direct-ci.com

Organizations & group practices 2

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 8

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1487673091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302913",
            "telephone_number": "631-742-3404",
            "fax_number": "516-742-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGUM",
        "first_name": "ALEXANDER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "230546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7863214",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02112870",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "43L481",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.