Mary Ann Fragola – Adult Health Nurse Practitioner

Key facts

NPI: 1508862079
Entity type: Individual (NPI type 1)
Primary specialty: Adult Health Nurse Practitioner 363LA2200X
License: F303023 (NY)
Practice address: 235 N Belle Mead Rd
E Setauket, NY 11733-3456
Phone: (631) 751-3000
Fax: (631) 675-2001
NPI assigned: Jun 21, 2005
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

North Shore Hematology Oncology Associates PC Specialist · Port Jefferson Station, NY · NPI 1396794574

Medicare reassignment Care Compare group NPD NY

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: State University of New York at Stony Brook, School of Medicine, 2000
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: North Shore Hematology Oncology Associates PC (474 clinicians)

Practice addresses (Care Compare)

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

Merit-based Incentive Payment System (MIPS)

Final score: 100 of 100 (group)
Promoting interoperability: 100
Improvement activities: 40

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NY
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20100508000017	NY	Practitioner - Nurse Practitioner	6608904883	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

Practice roles (1 of 5)

Organization	Specialty	Status	New patients
North Shore Hematology Oncology Associates PC		Current since Sep 1, 2000	Accepting new patients

Locations

365 E Montauk Hwy
Patchogue, NY 11772
Phone (631) 654-7370

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

49 Route 347
Port Jefferson Station, NY 11776
Phone (631) 751-0000

750 Old Country Rd
Riverhead, NY 11901

235 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 450-1200

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Health Nurse Practitioner	363LA2200X	F303023	NY	Yes

Addresses

Primary practice location

235 N Belle Mead Rd
E Setauket, NY 11733-3456

Mailing address

235 N Belle Mead Rd
E Setauket, NY 11733-3456
Phone (631) 751-3000

Other identifiers

Identifier	Type	State	Issuer
02242859	Medicaid	NY

Other providers in E Setauket, NY

All providers in E Setauket, NY · Adult Health Nurse Practitioner in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2014. 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.

Verify at the official NPI Registry.