Individual provider Active NPI

Dmitriy Berenzon, MD

  • Hematology & Oncology Physician
  • Poughkeepsie, NY
National Provider Identifier
1669631479
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
245284 Issued in NY
Practice address
159 Barnegat Rd Ste 101
Poughkeepsie, NY 12601-5402
Phone
(845) 454-1942
Fax
(845) 452-4638
NPI assigned
Jun 6, 2008
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 245284 NY Primary
Hematology & Oncology Physician 207RH0003X 2010-00928 NC

Addresses

Primary practice location

159 Barnegat Rd Ste 101
Poughkeepsie, NY 12601-5402

Mailing address

159 Barnegat Rd Ste 101
Poughkeepsie, NY 12601-5402
Phone (845) 454-1942

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
I20190506001099 NY Practitioner - Hematology/Oncology 8820120934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
22.06 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.54

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Valley Hematology Oncology Associates, RLLP CurrentSince May 8, 2019 Accepting new patients
North Shore Hematology Oncology Associates PC Hematology & Oncology CurrentSince May 8, 2019 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Mar 15, 2024 Accepting new patients

Locations

400 Westage Business Ctr Dr
Ste 103
Fishkill, NY 12524
Phone (845) 454-1942

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

159 Barnegat Rd
Ste 101
Poughkeepsie, NY 12601
Phone (845) 454-1942

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1669631479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BARNEGAT RD STE 101",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015402",
            "telephone_number": "845-454-1942",
            "fax_number": "845-452-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BARNEGAT RD STE 101",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015402",
            "telephone_number": "845-454-1942",
            "fax_number": "845-452-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENZON",
        "first_name": "DMITRIY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "245284",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2010-00928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.