Individual provider Active NPI

Sibi Pappachan, D.O.

  • Anesthesiology Physician
  • Mineola, NY
National Provider Identifier
1720392202
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
255084 Issued in NY
Practice address
259 First Street
Mineola, NY 11501
Phone
(516) 741-0570
Fax
(516) 741-8276
NPI assigned
Jul 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 255084 NY Primary

Addresses

Primary practice location

259 First Street
Mineola, NY 11501

Mailing address

216 First Street
Mineola, NY 11501
Phone (516) 741-0570

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spappachan307292@nyumc.direct-ci.com

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
I20101123000032 NY Practitioner - Anesthesiology 2365638913 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

301 E Main St
Bay Shore, NY 11706-8408
Phone (914) 666-8866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255084NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Jul 11, 2022 Accepting new patients
New York University CurrentSince May 17, 2022 Accepting new patients
Star Suites LLC Anesthesiology CurrentSince Sep 19, 2025 Accepting new patients
New York University CurrentSince May 17, 2022 Accepting new patients
Long Island Center for Digestive Health LLC CurrentSince Oct 1, 2018 Accepting new patients
New York University Anesthesiology Current Accepting new patients
Nassau Anesthesia Associates PC Anesthesiology Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

623 Stewart Ave
Ste 101
Garden City, NY 11530
Phone (516) 222-7827

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

106 Charles Lindbergh Blvd
Uniondale, NY 11553
Phone (516) 248-3737

Networks

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

Organizations & group practices 7

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1720392202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 FIRST STREET",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-741-0570",
            "fax_number": "516-741-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 FIRST STREET",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-741-0570",
            "fax_number": "516-741-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPACHAN",
        "first_name": "SIBI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "255084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spappachan307292@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 First Street",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.