NPIMap

Individual provider Active NPI

Evan C Nadal, DO

  • Family Medicine Physician
  • Riverhead, NY
National Provider Identifier
1619946548
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
150622 Issued in NY
Practice address
34 Commerce Dr
Suite 1
Riverhead, NY 11901-3118
Phone
(631) 727-1600
Fax
(631) 727-8320
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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 150622 NY Primary

Addresses

Primary practice location

34 Commerce Dr
Suite 1
Riverhead, NY 11901-3118

Mailing address

185 Old Country Rd
Riverhead, NY 11901-2121
Phone (631) 298-4479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000239 NY Practitioner - Internal MedicinePractitioner - Family Practice 6103810544 Reassigns benefits to 2 organizations
Practice locations: Riverhead, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peconic Bay Primary Medical CareGroup PAC ID 7113817602, 72 clinicians

Practice addresses (Care Compare)

34 Commerce Ave
Riverhead, NY 11901-3118
Phone (631) 727-1600

64 Commerce Ave
Riverhead, NY 11901-4455
Phone (631) 369-5000

Hospital & facility affiliations

  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • Tender Loving Care, an Amedisys Company Home health agency, Medford, NY, CCN 337260
  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hosptial CurrentSince Jan 3, 2012 Accepting new patients
Peconic Bay Primary Medical Care CurrentSince Jan 1, 2003 Accepting new patients
Central Suffolk Hospital CurrentSince Jan 3, 2012 Accepting new patients

Locations

1149 Old Country Rd
Ste E1
Riverhead, NY 11901
Phone (631) 591-2209

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

34 Commerce Ave
Ste 1
Riverhead, NY 11901
Phone (631) 369-4370

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

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: enadal25118@northwell.direct-ci.com

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 9

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1619946548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OLD COUNTRY RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012121",
            "telephone_number": "631-298-4479",
            "fax_number": "631-591-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 COMMERCE DR",
            "address_2": "SUITE 1",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013118",
            "telephone_number": "631-727-1600",
            "fax_number": "631-727-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADAL",
        "first_name": "EVAN",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "150622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.