Individual provider Active NPI

Denise F.O. D'Ambrosia, RN, FNP-C, PROF

  • Family Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1558509828
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F332998-1 Issued in NY
Practice address
T16-020 HSC
Stony Brook, NY 11794-8171
Phone
(631) 444-1062
Fax
(631) 444-1054
NPI assigned
Jan 26, 2009
Last updated
Jan 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F332998-1 NY Primary

Addresses

Primary practice location

T16-020 HSC
Stony Brook, NY 11794-8171

Mailing address

47A Sally la
Ridge, NY 11961-2429
Phone (631) 345-5198

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110818000601 NY Practitioner - Nurse Practitioner 6901076496 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
332998NYMDLicensed Practical Nurse
F332998-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peconic Bay Primary Medical Care CurrentSince Jan 1, 2018 Accepting new patients

Locations

34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1558509828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47A SALLY LA",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119612429",
            "telephone_number": "631-345-5198",
            "fax_number": "631-345-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "T16-020 HSC",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948171",
            "telephone_number": "631-444-1062",
            "fax_number": "631-444-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMBROSIA",
        "first_name": "DENISE",
        "middle_name": "F.O.",
        "name_prefix": "Prof.",
        "credential": "RN, FNP-C, PROF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332998-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.