Individual provider Active NPI

Carelle Akilah Cherebin, D.O.

  • Family Medicine Physician
  • Westhampton Beach, NY
National Provider Identifier
1598112690
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
305159 Issued in NY
Practice address
147 Beach Rd (at Montauk Highway)
Westhampton Beach, NY 11978-1733
Phone
(631) 288-7746
Fax
(631) 288-7111
NPI assigned
May 18, 2016
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 305159 NY Primary

Addresses

Primary practice location

147 Beach Rd (at Montauk Highway)
Westhampton Beach, NY 11978-1733

Mailing address

72 Sunrise CT Apt 4
Moriches, NY 11955-2019
Phone (917) 533-0077

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
I20200812002791 NY Practitioner - Family Practice 2961739545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Floating Hospital IncGroup PAC ID 0547367120, 17 clinicians

Practice addresses (Care Compare)

2101 41St Ave
Long Island City, NY 11101-4801
Phone 7187842240144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305159NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Floating Hospital Inc. CurrentSince Sep 26, 2022 Accepting new patients
The Floating Hospital Inc. Current Accepting new patients
The Floating Hospital Inc. CurrentSince Sep 26, 2022 Accepting new patients
Southampton Hospital Association Past Accepting new patients
University Hospital at Stony Brook Past Accepting new patients
The Floating Hospital Inc. Past Accepting new patients

Locations

1029 41st Ave
Long Island City, NY 11101
Phone (718) 361-6266

2101 41st Ave
Long Island City, NY 11101
Phone (718) 691-6307

Networks

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

Interoperability endpoints

  • Direct secure messaging: carelle.cherebin.1@22829.direct.athenahealth.com

Organizations & group practices 6

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": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1598112690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 SUNRISE CT APT 4",
            "city": "MORICHES",
            "state": "NY",
            "postal_code": "119552019",
            "telephone_number": "917-533-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 BEACH RD (AT MONTAUK HIGHWAY)",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119781733",
            "telephone_number": "631-288-7746",
            "fax_number": "631-288-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEREBIN",
        "first_name": "CARELLE",
        "middle_name": "AKILAH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "305159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westhampton Beach, NY

Sources for this page

Verify at the official NPI Registry.