NPIMap

Individual provider Active NPI

Daniel R. Montellese, MD

  • Interventional Cardiology Physician
  • Stony Brook, NY
National Provider Identifier
1770679557
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
241554 Issued in NY
Practice address
1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790
Phone
(631) 941-2273
Fax
(631) 941-2501
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 241554 NY
Interventional Cardiology Physician 207RI0011X 241554-1 NY
Interventional Cardiology Physician 207RI0011X 241554 NY Primary

Addresses

Primary practice location

1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790

Mailing address

1320 Stony Brook Road
BLDG D, Suite 100
Stony Brook, NY 11790
Phone (631) 941-2273

Other identifiers 1

IdentifierTypeStateIssuer
03427332MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniel.montellese@sbcm.cernerdirect.com

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
I20090709000673 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8426100116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 941-2000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241554-1NYMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Apr 1, 2013 Accepting new patients
Cardiac Ekg Interpretation, P. C. CurrentSince Jan 1, 2012 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients
Stony Brook Community Medical, P.C. Internal Medicine Past Accepting new patients

Locations

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

220 N Belle Mead Rd
Ste A
Setauket, NY 11733
Phone (631) 941-2273

676 County Road 39A
Southampton, NY 11968
Phone (631) 283-2070

1320 Stony Brook Rd
Ste 100
Stony Brook, NY 11790
Phone (631) 941-2273

100 Nicolls Rd
#13202
Stony Brook, NY 11794

1320 Stony Brook Rd
Bldg D100
Stony Brook, NY 11790
Phone (631) 941-2273

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: daniel.montellese@sbcm.cernerdirect.com

Organizations & group practices 4

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 8

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1770679557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK ROAD",
            "address_2": "BLDG D, SUITE 100",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-941-2273",
            "fax_number": "631-941-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD STE 100",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-941-2273",
            "fax_number": "631-941-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTELLESE",
        "first_name": "DANIEL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "241554",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "241554-1",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "241554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03427332",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.montellese@sbcm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1320 Stony Brook Rd Ste 100",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.