Active NPI
Nicholas Alexander Avitabile, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Monroe, NY
National Provider Identifier
1750607602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 264177
- Practice address
- 855 State Route 17M
Monroe, NY 10950-1600 - Phone
- (845) 703-6999
- Fax
- (845) 703-6297
- NPI assigned
- Apr 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 264177 | NY | Primary |
Addresses
Primary practice location
855 State Route 17M
Monroe, NY 10950-1600
Mailing address
155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03461016 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nicholas.avitabilemd.p1@direct.crystalrun.nextgenshare.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
300 Crystal Run Rd
Middletown, NY 10941-4069
Phone (845) 692-6999
Hospital & facility affiliations
- Garnet Health Medical Center
- Morristown Medical Center
- Bon Secours Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.01 of 100
- Quality
- 73.63
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Run Healthcare Physicians LLP | Endocrinology, Diabetes & Metabolism | Current | Accepting new patients |
| Crystal Run Healthcare Physicians LLP | Current | Accepting new patients |
Locations
155 Crystal Run Rd
Middletown, NY 10941
300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999
855 State Route 17M
Monroe, NY 10950
Phone (845) 615-6999
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Organizations & group practices 2
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.
-
- General Practice Physician
- Middletown, NY
- NPI 1952376410
Endocrinology, Diabetes & Metabolism
-
- Durable Medical Equipment & Medical Supplies
- Monroe, NY
- NPI 1558857425
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Jervis, NY
- NPI 1659360709
-
- General Acute Care Hospital
- Middletown, NY
- NPI 1609875772
-
- General Acute Care Hospital
- Morristown, NJ
- NPI 1053384776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596153600000",
"number": "1750607602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 CRYSTAL RUN RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109414028",
"telephone_number": "845-703-6999",
"fax_number": "845-703-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 STATE ROUTE 17M",
"city": "MONROE",
"state": "NY",
"postal_code": "109501600",
"telephone_number": "845-703-6999",
"fax_number": "845-703-6297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVITABILE",
"first_name": "NICHOLAS",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-18",
"last_updated": "2020-07-31",
"certification_date": "2020-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "NY",
"license": "264177",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03461016",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nicholas.avitabilemd.p1@direct.crystalrun.nextgenshare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "855 State Route 17M",
"city": "Monroe",
"state": "NY",
"country_code": "US",
"postal_code": "109501600",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Monroe, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.