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Individual provider Active NPI

Pollytia Irene Panagiotou

  • Internal Medicine Physician
  • Miller Place, NY
National Provider Identifier
1790149177
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
306758 Issued in NY
Practice address
43 Radio Ave
Miller Place, NY 11764-3125
Phone
(631) 821-8911
Fax
(631) 821-8912
NPI assigned
Apr 11, 2016
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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 306758 NY Primary

Addresses

Primary practice location

43 Radio Ave
Miller Place, NY 11764-3125

Mailing address

500 Commack Rd Unit 206
Commack, NY 11725-5022
Phone (631) 675-2125

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Pollytia.Panagiotou@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
I20201002001523 NY Practitioner - Internal Medicine 4486983160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
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) 444-1560

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

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

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

PO Box
Suite 1554
Stony Brook, NY 11790-0989

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306758NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Oct 25, 2021 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Sep 1, 2020 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Internal Medicine CurrentSince Oct 25, 2021 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

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

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

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1790149177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COMMACK RD UNIT 206",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255022",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 RADIO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643125",
            "telephone_number": "631-821-8911",
            "fax_number": "631-821-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANAGIOTOU",
        "first_name": "POLLYTIA",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "306758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Pollytia.Panagiotou@sbcm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "43 Radio Ave",
            "city": "Miller Place",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117643125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

Verify at the official NPI Registry.