Individual provider Active NPI

Vemkata Maddineni, M.D.

  • Anesthesiology Physician
  • West Islip, NY
National Provider Identifier
1811969546
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
199936-1 Issued in NY
Practice address
1000 Montauk Hwy
Good Samaritan Hospital
West Islip, NY 11795-4927
Phone
(631) 376-4088
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 199936-1 NY Primary
Anesthesiology Physician 207L00000X 35471 WV

Addresses

Primary practice location

1000 Montauk Hwy
Good Samaritan Hospital
West Islip, NY 11795-4927

Mailing address

165 Coachman PL W
Syosset, NY 11791-3059
Phone (516) 364-6414

Other practice location 1

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other identifiers 2

IdentifierTypeStateIssuer
01710163MedicaidNY
1811969546MedicaidWV

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040911000127 NY Practitioner - Anesthesiology 4082681945 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35471WVMDLicensed Practical Nurse
199936-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical CurrentSince Mar 1, 2020 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Long Island Anesthesiologists, PLLC Anesthesiology CurrentSince Aug 7, 2006 Accepting new patients
New York University Medical Center Past Accepting new patients
Nassau Anesthesia Associates, P.C. Anesthesiology PastSince May 7, 2023 Accepting new patients

Locations

369 E Main St
Ste 18
East Islip, NY 11730
Phone (631) 277-1600

210 W Park Ave
Long Beach, NY 11561
Phone (516) 431-4800

3 Boyle Rd
Selden, NY 11784
Phone (631) 716-6000

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

160 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 364-4200

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1811969546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COACHMAN PL W",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913059",
            "telephone_number": "516-364-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "address_2": "GOOD SAMARITAN HOSPITAL",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDINENI",
        "first_name": "VEMKATA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "199936-1",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "35471",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01710163",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811969546",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.