Demetrius Moutsiakis, M.D., M.P.H.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

212315-1 Issued in NY

Practice address

400 Horseblock Rd
Farmingville, NY 11738-1252

Phone

(631) 698-1552

NPI assigned

Apr 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

General PracticeAlso: Physical Medicine and Rehabilitation, Preventive Medicine

Education

State University of New York at Stony Brook, School of Medicine, 1997

Medicare assignment

May accept Medicare assignment

Group practices

Saw Medical Services PCGroup PAC ID 3072757319, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Saw Medical Services PC

  • Physical Medicine & Rehabilitation Physician
  • Farmingville, NY
  • NPI 1922373380
  Medicare reassignment Care Compare group NPD Authorized official
• Horseblock Medical PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Farmingville, NY
  • NPI 1437460805
  NPD (past) Authorized official

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1861717860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HORSEBLOCK RD",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381252",
            "telephone_number": "631-698-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HORSEBLOCK RD",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381252",
            "telephone_number": "631-698-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTSIAKIS",
        "first_name": "DEMETRIUS",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-01",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NY",
            "license": "212315-1",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "212315-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Montgomery
• Amelia Marie Montleon, BA
• Nicolle Morici, L.MT
• Dashella Roxanne Mortley
• Allen Motola, DDS
• Michaela Mudaro
• Margaret Ann Mungo, RN
• Kristie-Lee Denise Murphy
• National Vision Inc
• Jacquelyn Natorski

• General Practice Physician in Farmingville, NY
• Providers in Farmingville, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.