NPIMap

Individual provider Active NPI

Dipa R Avichal, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Lake Success, NY
National Provider Identifier
1881074060
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
303282 Issued in NY
Practice address
1999 Marcus Avenue
Suite 216
Lake Success, NY 11042
Phone
(516) 775-4545
Fax
(516) 775-4646
NPI assigned
Jun 3, 2015
Last updated
Jul 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 303282 NY Primary

Addresses

Primary practice location

1999 Marcus Avenue
Suite 216
Lake Success, NY 11042

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0480

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
I20200828000653 NY Practitioner - Endocrinology 9133452543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Rowan University School of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

101 Grand Ave
Unit 105
Massapequa, NY 11758-4958
Phone (516) 795-2626

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Sep 1, 2021 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, PC CurrentSince Sep 1, 2021 Accepting new patients
CHS Physician Partners, PC Internal Medicine Current Accepting new patients

Locations

101 Grand Ave
Unit 105
Massapequa, NY 11758
Phone (516) 795-2626

510 Hicksville Rd
Massapequa, NY 11758
Phone (516) 729-2626

1999 Marcus Ave
Ste 216
New Hyde Park, NY 11042
Phone (516) 775-4545

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

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

Interoperability endpoints

  • Direct secure messaging: davichal125429@direct-chsli.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1881074060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-0480",
            "fax_number": "631-444-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 MARCUS AVENUE",
            "address_2": "SUITE 216",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-775-4545",
            "fax_number": "516-775-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVICHAL",
        "first_name": "DIPA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "303282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Success, NY

Sources for this page

Verify at the official NPI Registry.