Active NPI
Adam Joseph Korzenko, M.D.
- Dermatology Physician
- Port Jefferson Station, NY
National Provider Identifier
1538356308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 242407-1
- Practice address
- 6 Medical Drive
Port Jefferson Professional Park, Suite D
Port Jefferson Station, NY 11776 - Phone
- (631) 928-7922
- Fax
- (631) 928-9246
- NPI assigned
- Sep 26, 2007
- Last updated
- Aug 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 242407-1 | NY | Primary |
Addresses
Primary practice location
6 Medical Drive
Port Jefferson Professional Park, Suite D
Port Jefferson Station, NY 11776
Mailing address
181 Belle Meade Rd
Suite 6
East Setauket, NY 11733
Phone (631) 444-4200
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
- Dermatology
- Education
- State University of New York at Stony Brook, School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1320 Stony Brook Rd
Suite 200
Stony Brook, NY 11790-2215
Phone (631) 444-4200
6 Medical Dr
Suite D
Port Jefferson Station, NY 11776-1594
Phone (631) 982-7922
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 5152 |
| Removal or shaving of skin growth | 670 |
| Skin biopsy | 148 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242407-1 | NY | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospital at Stony Brook | Current | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- adam.korzenko1@direct.stonybrookmedicine.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dermatology Physician
- Port Jefferson Station, NY
- NPI 1902837396
-
- Dermatology Physician
- Stony Brook, NY
- NPI 1497700819
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Stony Brook Southampton Hospital
- 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": "1190764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1538356308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 BELLE MEADE RD",
"address_2": "SUITE 6",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "11733",
"telephone_number": "631-444-4200",
"fax_number": "631-444-4276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 MEDICAL DRIVE",
"address_2": "PORT JEFFERSON PROFESSIONAL PARK, SUITE D",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "11776",
"telephone_number": "631-928-7922",
"fax_number": "631-928-9246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORZENKO",
"first_name": "ADAM",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-26",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "242407-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.