Individual provider Active NPI

Swagato Bhattacharyya, DO

  • Psychiatry Physician
  • Port Jefferson, NY
National Provider Identifier
1720585458
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
315451 Issued in NY
Practice address
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone
(631) 686-2517
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 315451 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

75 N Country Rd
Port Jefferson, NY 11777-2119

Mailing address

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 686-2517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MO, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220623001570 NY Practitioner - Psychiatry 2062766538 Reassigns benefits to 3 organizations
I20231102003018 MO Practitioner - Psychiatry 2062766538 Reassigns benefits to 1 organization
I20231107000161 NJ Practitioner - Psychiatry 2062766538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York College of Osteo Medicine of New York Institute of Technology, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD Psychiatry Services PLLCGroup PAC ID 4082049036, 206 clinicians
John T Mather Memorial HospitalGroup PAC ID 1254237753, shared by 6 NPIs, 176 clinicians

Practice addresses (Care Compare)

109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255

125 Oakland Ave
Suite 303
Port Jefferson, NY 11777-2130
Phone (631) 928-3122

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315451NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jul 13, 2022 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Sep 5, 2023 Accepting new patients
John T. Mather Memorial Hospital Psychiatry Current Accepting new patients
MCCD New Jersey Psychiatry Services LLC Psychiatry CurrentSince Jul 15, 2023 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Sep 5, 2023 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Oct 13, 2023 Accepting new patients

Locations

231 S Bemiston Ave
Ste 800
Saint Louis, MO 63105
Phone (214) 814-0994

525 Route 73 N
Ste 117
Marlton, NJ 08053
Phone (609) 200-0444

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

125 Oakland Ave
Ste 303
Port Jefferson, NY 11777
Phone (631) 729-2140

70 N Country Rd
Ste 205
Port Jefferson, NY 11777
Phone (631) 686-1414

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1720585458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-686-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-686-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTACHARYYA",
        "first_name": "SWAGATO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "315451",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.