NPIMap

Individual provider Active NPI

David P Mangiameli, MD

  • Surgery Physician
  • East Patchogue, NY
National Provider Identifier
1861659823
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
247678 Issued in NY
Practice address
100 Hospital Rd Ste 201
Attn: Liz Knuerr
East Patchogue, NY 11772-8814
Phone
(631) 687-4237
Fax
(631) 447-3012
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 247678 NY Primary

Addresses

Primary practice location

100 Hospital Rd Ste 201
Attn: Liz Knuerr
East Patchogue, NY 11772-8814

Mailing address

100 Hospital Rd Ste 201
Attn- Liz Knuerr
East Patchogue, NY 11772-8814
Phone (631) 687-4237

Other identifiers 1

IdentifierTypeStateIssuer
02977484MedicaidNY

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
I20080612000174 NY Practitioner - General SurgeryPractitioner - Surgical Oncology 2365465457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
Midwestern University, Chicago College of Osteopathic Med, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

365 E Main St
Patchogue, NY 11772-3145
Phone (631) 751-3000

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy39
Melanoma (skin cancer) excision15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247678NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Apr 1, 2021 Accepting new patients
Great South Bay Chiropractic Office Current Accepting new patients

Locations

100 Hospital Rd
Ste 106
East Patchogue, NY 11772
Phone (631) 228-5800

365 E Montauk Hwy
Patchogue, NY 11772
Phone (631) 654-7370

214 E Main St
Patchogue, NY 11772

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

750 Old Country Rd
Bldg 2
Riverhead, NY 11901
Phone (631) 450-1500

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

640 County Road 39
Southampton, NY 11968

40 Main St
Westhampton Beach, NY 11978
Phone (631) 288-1954

Networks

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

Interoperability endpoints

  • Direct secure messaging: dmangiameli509571@nyumc.direct-ci.com
  • Direct secure messaging: dmangiameli65729@northwell.direct-ci.com

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.

Hospital & facility affiliations 12

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252022400000",
    "number": "1861659823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD STE 201",
            "address_2": "ATTN- LIZ KNUERR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728814",
            "telephone_number": "631-687-4237",
            "fax_number": "631-447-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD STE 201",
            "address_2": "ATTN: LIZ KNUERR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728814",
            "telephone_number": "631-687-4237",
            "fax_number": "631-447-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIAMELI",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2009-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "247678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02977484",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.