NPIMap

Individual provider Active NPI

Robin S Dacosta, MD

  • Internal Medicine Physician
  • Ronkonkoma, NY
National Provider Identifier
1730306507
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
188230 Issued in NY
Practice address
217 Portion Rd
Ronkonkoma, NY 11779-2341
Phone
(631) 758-3100
Fax
(631) 758-3168
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 188230 NY Primary

Addresses

Primary practice location

217 Portion Rd
Ronkonkoma, NY 11779-2341

Mailing address

1 Research Rd
Ridge, NY 11961-2701
Phone (631) 758-3100

Other identifiers 1

IdentifierTypeStateIssuer
01901106MedicaidNY

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
I20040330001875 NY Practitioner - Internal Medicine 4082606173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 1989
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)

365 E Main St
Patchogue, NY 11772-3145
Phone (631) 751-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Port Jeff Medicine, P.C. Internal Medicine Current Accepting new patients
Mid-Suffolk Medical Care PC CurrentSince Feb 1, 2016 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Sep 1, 2020 Accepting new patients

Locations

6277 Jericho Tpke
Commack, NY 11725
Phone (631) 462-6644

365 E Montauk Hwy
Patchogue, NY 11772
Phone (631) 654-7370

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

1 Research Rd
Ridge, NY 11961

217 Portion Rd
Ronkonkoma, NY 11779
Phone (631) 588-4860

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

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEDIBA

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1730306507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RESEARCH RD",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119612701",
            "telephone_number": "631-758-3100",
            "fax_number": "631-758-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 PORTION RD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117792341",
            "telephone_number": "631-758-3100",
            "fax_number": "631-758-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "ROBIN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "188230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01901106",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.