NPIMap

Individual provider Active NPI

Reza Dashti, M.D.,PH.D.

  • Neurological Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1801167895
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
292928 Issued in NY
Practice address
New York Spine and Brain Surgery HSC T12 RM 080
Stony Brook, NY 11794
Phone
(631) 444-1116
Fax
(631) 444-6230
NPI assigned
Jan 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036.139458 IL
Neurological Surgery Physician 207T00000X 292928 NY Primary

Addresses

Primary practice location

New York Spine and Brain Surgery HSC T12 RM 080
Stony Brook, NY 11794

Mailing address

New York Spine and Brain Surgery HSC T12 RM 080
Stony Brook, NY 11794-8122
Phone (631) 444-1116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160208001147 IL Practitioner - Interventional RadiologyPractitioner - Neurosurgery 1658675988 Reassigns benefits to 2 organizations
I20180430000188 NY Practitioner - NeurosurgeryPractitioner - Interventional Radiology 1658675988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: Interventional Radiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.139458ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Spine & Brain Surgery, University Faculty Practice Corporatio Neurological Surgery CurrentSince Jun 4, 2018 Accepting new patients
Mount Sinai Community Foundation Dba Sinai Medical Group CurrentSince Dec 30, 2015 Accepting new patients
The Board of Trustees of the University of Illinois Neurological Surgery CurrentSince Dec 8, 2015 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Dec 8, 2015 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Dec 30, 2015 Accepting new patients

Locations

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: reza.dashti@direct.stonybrookmedicine.edu

Organizations & group practices 8

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 9

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": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1801167895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEW YORK SPINE AND BRAIN SURGERY HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948122",
            "telephone_number": "631-444-1116",
            "fax_number": "631-865-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEW YORK SPINE AND BRAIN SURGERY HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-1116",
            "fax_number": "631-444-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASHTI",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.,PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-23",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036.139458",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "292928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.