NPIMap

Individual provider Active NPI

Davide Debellis, M.D.

  • Internal Medicine Physician
  • Poughkeepsie, NY
National Provider Identifier
1871512202
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
168550 Issued in NY
Practice address
1 Webster Ave
Suite 301
Poughkeepsie, NY 12601-1361
Phone
(845) 790-6100
Fax
(845) 345-9966
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 168550 NY Primary

Addresses

Primary practice location

1 Webster Ave
Suite 301
Poughkeepsie, NY 12601-1361

Mailing address

243 North Rd
Suite 304
Poughkeepsie, NY 12601-1172
Phone (845) 451-7251

Other identifiers 1

IdentifierTypeStateIssuer
01338412MedicaidNY

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
I20100312000018 NY Practitioner - Internal Medicine 5294860540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Webster Ave
Suite 307
Poughkeepsie, NY 12601-1365
Phone (845) 790-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168550NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of the Hudson Valley P.C. Internal Medicine CurrentSince Sep 1, 2013 Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Sep 1, 2013 Accepting new patients

Locations

1 Webster Ave
Ste 301
Poughkeepsie, NY 12601
Phone (845) 483-5858

1 Webster Ave
Ste 307
Poughkeepsie, NY 12601
Phone (845) 471-1002

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

Networks

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

Interoperability endpoints

  • Direct secure messaging: ddebellis@premiermedicalhv.medentdirect.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 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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1871512202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 NORTH RD",
            "address_2": "SUITE 304",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011172",
            "telephone_number": "845-451-7251",
            "fax_number": "845-451-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE",
            "address_2": "SUITE 301",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011361",
            "telephone_number": "845-790-6100",
            "fax_number": "845-345-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBELLIS",
        "first_name": "DAVIDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "168550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01338412",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.