Theofanis Mitsinikos, DO, PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

235458 Issued in NY

Legal business name

THEOFANIS MITSINIKOS, DO, PC

Practice address

2500 Nesconset Hwy BLDG 3C
Stony Brook, NY 11790-2551

Phone

(631) 751-2400

Fax

(631) 751-8323

NPI assigned

May 22, 2017

Last updated

May 22, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theofanis Mitsinikos, DONPI 1467624064

Title

Owner

Phone

(631) 751-2400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theofanis Mitsinikos, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Stony Brook, NY
  • NPI 1467624064
  Medicare reassignment NPD Authorized official
• Nicoleta Ionica, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Bay Shore, NY
  • NPI 1033388376
  NPD
• Margaret Cibotti Alex, NP

  • Adult Health Nurse Practitioner
  • Stony Brook, NY
  • NPI 1659554343
  NPD (past)
• Rilee Chowlera, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Bronx, NY
  • NPI 1548267735
  NPD (past)
• Monika Datt, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Stony Brook, NY
  • NPI 1578716262
  NPD (past)
• Phyllis Migdal, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Stony Brook, NY
  • NPI 1144246885
  NPD (past)
• Jennifer Moldovan, P.A.

  • Medical Physician Assistant
  • Smithtown, NY
  • NPI 1811160559
  NPD (past)
• Joseph Terrana, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Nesconset, NY
  • NPI 1598714354
  NPD (past)
• Lina Mitchell, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Mason, OH
  • NPI 1417906454
  NPD (past)
• Pragnesh M. Patel, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Pittsburg, CA
  • NPI 1053488866
  NPD (past)

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495411200000",
    "number": "1861929861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 3C",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 3C",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902551",
            "telephone_number": "631-751-2400",
            "fax_number": "631-751-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEOFANIS MITSINIKOS, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A",
        "authorized_official_last_name": "MITSINIKOS",
        "authorized_official_first_name": "THEOFANIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-751-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "235458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Kids OT Workshop, LLC
• The Nguyen Center, Inc.
• The Speech Language Place
• The Speech Language Place, SLP, PC (The Speech Language Place, SLP)
• The Speech Language Place, SLP, PC
• Sander Thervil
• Anu Varughese Thomas, NP
• Cole Thomas
• Jonathan Nelson Thomas, MD
• Katie Thomas, NP

• Endocrinology, Diabetes & Metabolism Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.