Individual provider Active NPI

Lesley Small-Harary, MD

  • Pediatrics Physician
  • Stony Brook, NY
National Provider Identifier
1588980288
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
268402 Issued in NY
Practice address
Stony Brook Childrens Hospital
HSC Level 11 RM 080
Stony Brook, NY 11794-8111
Phone
(631) 444-8115
Fax
(631) 444-6045
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 268402 NY Primary

Addresses

Primary practice location

Stony Brook Childrens Hospital
HSC Level 11 RM 080
Stony Brook, NY 11794-8111

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-8115

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
I20161013001439 NY Practitioner - Pediatric MedicinePractitioner - Gastroenterology 5698063238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4 Technology Dr
East Setauket, NY 11733-4080
Phone (631) 444-5437

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Pediatrics CurrentSince Sep 1, 2016 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Past Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Past Accepting new patients

Locations

600 Montauk Hwy
Ste A
Center Moriches, NY 11934
Phone (631) 638-2900

500 Commack Rd
Ste 104
Commack, NY 11725
Phone (631) 638-0150

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

4 Smith Haven Mall
Ste 101
Lake Grove, NY 11755
Phone (631) 444-7337

4 Technology Dr
Setauket, NY 11733
Phone (631) 444-2700

Networks

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

Interoperability endpoints

  • Direct secure messaging: lesley.small-harary@direct.stonybrookmedicine.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1588980288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK CHILDRENS HOSPITAL",
            "address_2": "HSC LEVEL 11 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-8115",
            "fax_number": "631-444-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL-HARARY",
        "first_name": "LESLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "268402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.