Individual provider Active NPI

Monika Datt, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Stony Brook, NY
National Provider Identifier
1578716262
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
265812 Issued in NY
Practice address
2500 Nesconset Hwy BLDG 3C
Stony Brook, NY 11790-2551
Phone
(631) 751-2400
Fax
(631) 751-8323
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 265812 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy BLDG 3C
Stony Brook, NY 11790-2551

Mailing address

170 Maple Ave
Ste G-1
White Plains, NY 10601-4767
Phone (631) 751-2400

Other identifiers 1

IdentifierTypeStateIssuer
265812OtherNYNY LICENSE 265812

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120910000136 NY Practitioner - Endocrinology 9638327026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

170 Maple Ave
FL 4
White Plains, NY 10601-4710
Phone (914) 328-8444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265812NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Physician Services PC CurrentSince Jan 1, 2023 Accepting new patients
Theofanis Mitsinikos, DO, PC Endocrinology, Diabetes & Metabolism PastSince May 1, 2017 Accepting new patients
Maple Medical, LLP Past Accepting new patients

Locations

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

750 White Plains Rd
Scarsdale, NY 10583
Phone (914) 597-3880

170 Maple Ave
Fl 4
White Plains, NY 10601
Phone (914) 328-8444

170 Maple Ave
Ste G-1
White Plains, NY 10601
Phone (914) 328-0932

Networks

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

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 1

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1578716262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MAPLE AVE",
            "address_2": "STE G-1",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014767",
            "telephone_number": "631-751-2400",
            "fax_number": "631-751-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 3C",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902551",
            "telephone_number": "631-751-2400",
            "fax_number": "631-751-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATT",
        "first_name": "MONIKA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "265812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE 265812",
            "identifier": "265812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.