Gregory Michael Despotidis

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

332076 Issued in NY

Practice address

Stony Brook Health Science Center T16
Room 020
Stony Brook, NY 11790-8160

Phone

(631) 444-7411

NPI assigned

Apr 29, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

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

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1508449323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK HEALTH SCIENCE CENTER T16",
            "address_2": "ROOM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117908160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK HEALTH SCIENCE CENTER T16",
            "address_2": "ROOM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117908160",
            "telephone_number": "631-444-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPOTIDIS",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "332076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amruta G. Desai, DO, MPH, MBA
• Megan Desai, DO
• Sanket Girish Desai
• Zalak Desai
• Catherine Desmond, MD
• Kelly Elyse Detoy, MD
• Stephan Nickolas Deturris
• Veronique Regina Deutsch-Anzalone, PSYD
• Alma Magick Devine, M.D
• Catherine Grace Devitt, MD

• Internal Medicine Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.