Active NPI
Deborah Ann Nagle, MD
- Colon & Rectal Surgery Physician
- Boston, MA
National Provider Identifier
1487680427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 229284
- Practice address
- 330 Brookline Avenue
Stoneman 9
Boston, MA 02215-5400 - Phone
- (617) 667-4159
- Fax
- (617) 667-2978
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | MA079886 | NJ | |
| Colon & Rectal Surgery Physician | 208C00000X | MD043640L | PA | |
| Colon & Rectal Surgery Physician | 208C00000X | 229284 | MA | Primary |
Addresses
Primary practice location
330 Brookline Avenue
Stoneman 9
Boston, MA 02215-5400
Mailing address
330 Brookline Avenue
Stoneman 9
Boston, MA 02215-5400
Phone (617) 667-4179
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 229284 | Other | MA | MASS MEDICAL LICENSING BOARD |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Colorectal Surgery (Proctology)
- Education
- Perelman School of Med at the University of Pennsylvania, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 13 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA079886 | NJ | MD | Colon & Rectal Surgery Physician |
| MD043640L | PA | MD | Colon & Rectal Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospital at Stony Brook | Current | Accepting new patients | |
| Stony Brook Surgical Associates, University Faculty Practice Corporati | Current | Accepting new patients |
Locations
4 Smith Haven Mall
Ste 200
Lake Grove, NY 11755
Phone (631) 444-4121
37 Research Way
Setauket, NY 11733
Phone (631) 444-4121
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- deborah.nagle@direct.stonybrookmedicine.edu
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.
-
- Surgery Physician
- Stony Brook, NY
- NPI 1063468536
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Farmingdale, NY
- NPI 1780670711
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350604800000",
"number": "1487680427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVENUE",
"address_2": "STONEMAN 9",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-4179",
"fax_number": "617-667-2978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVENUE",
"address_2": "STONEMAN 9",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-4159",
"fax_number": "617-667-2978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGLE",
"first_name": "DEBORAH",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2012-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "NJ",
"license": "MA079886",
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "PA",
"license": "MD043640L",
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "MA",
"license": "229284",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS MEDICAL LICENSING BOARD",
"identifier": "229284",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.