NPIMap

Individual provider Active NPI

Alexandra Hailey Donnelly, DO

  • Emergency Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1518543156
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
328616 Issued in NY
Practice address
101 Nicolls Road
HSC Level 4, 050
Stony Brook, NY 11794
Phone
(631) 444-3880
Fax
(631) 444-3919
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 328616 NY Primary

Addresses

Primary practice location

101 Nicolls Road
HSC Level 4, 050
Stony Brook, NY 11794

Mailing address

101 Nicolls Road
HSC Level 4, 050
Stony Brook, NY 11794
Phone (631) 444-3880

Other practice location 1

50 New York Ave # 25A
Smithtown, NY 11787-3448
Phone (631) 862-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030003187 NY Practitioner - Emergency Medicine 4880127752 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siena Emergency Medical Services PCGroup PAC ID 9830257625, 15 clinicians

Practice addresses (Care Compare)

50 Route 25a
Smithtown, NY 11787-1348
Phone (240) 686-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
328616NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Siena Emergency Medical Services, P.C. Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Port Emergency Medical Services, P.C. Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Stony Brook Emergency Physicians, University Faculty Practice Corporat Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Organizations & group practices 3

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 7

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1518543156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "HSC LEVEL 4, 050",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-3880",
            "fax_number": "631-444-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "HSC LEVEL 4, 050",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-3880",
            "fax_number": "631-444-3919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 New York Ave # 25A",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117873448",
            "country_code": "US",
            "telephone_number": "631-862-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "ALEXANDRA",
        "middle_name": "HAILEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "328616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.