Nastassia De Souza, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

323186 Issued in NY

Practice address

515 Bellport Ave
Bellport, NY 11713-1711

Phone

(631) 288-7120

Fax

(929) 455-9423

NPI assigned

Jul 8, 2015

Last updated

Sep 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

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 2

Specialty

Endocrinology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: ndesouza550339@nyumc.direct-ci.com

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.

• New York University

  dba NYU Faculty Group Practice

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  Internal Medicine, NY

  Medicare reassignment Care Compare group NPD
• Wellspan Medical Group

  dba WellSpan Digestive Health

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment NPD
• New York University

  dba NYU Langone Ambulatory Care Chelsea

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613

  Internal Medicine

  NPD
• Wellspan Medical Group

  dba WellSpan Pediatric Surgical Specialist

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  dba WellSpan Family Medicine

  • Family Medicine Physician
  • Chambersburg, PA
  • NPI 1144035601
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• NYU Langone Hospitals

  dba NYU Langone Hospitals - Suffolk

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Patchogue, NY
  • NPI 1013724061

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  dba NYU Langone Hospital - Suffolk

  • General Acute Care Hospital
  • Patchogue, NY
  • NPI 1831910355
  Care Compare affiliation

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1891178836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BELLPORT AVE",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131711",
            "telephone_number": "631-288-7120",
            "fax_number": "929-455-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BELLPORT AVE",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131711",
            "telephone_number": "631-288-7120",
            "fax_number": "929-455-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SOUZA",
        "first_name": "NASTASSIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2023-09-18",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT209620",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "323186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103292986",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Sue Cornacchiulo, R.N.
• Gabrielle Maria Coyne, LMSW
• CVS Albany LLC (CVS Pharmacy # 00848)
• Daniel Zito DMD PLLC (Bellport Village Dentist)
• Conrado De la Garza
• Natalie Suhei Degrijze
• Jillian Elizabeth Dejohn, LPN
• Edward Deneve, O.D.
• Joan M. Desio, L.C.S.W.
• Anthonette Rosemarie Desire, M.D.

• Endocrinology, Diabetes & Metabolism Physician in Bellport, NY
• Providers in Bellport, 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 Sep 18, 2023; 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.