Organization Active NPI

Diabetes & Endocrine PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Riverhead, NY
National Provider Identifier
1902560964
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
DIABETES & ENDOCRINE PLLC
Practice address
632 Roanoke Ave
Riverhead, NY 11901-2728
Phone
(631) 939-2127
Fax
(718) 892-0736
NPI assigned
Oct 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Dr. Charmian Cohen, MDNPI 1003929043
Title
President
Phone
(631) 939-2127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

632 Roanoke Ave
Riverhead, NY 11901-2728

Mailing address

632 Roanoke Ave
Riverhead, NY 11901-2728
Phone (631) 939-2127

Other practice location 1

61 Tyler Dr
Riverhead, NY 11901-5022
Phone (631) 939-2127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211109000582 NY Part B Supplier - Clinic/Group Practice 1759770027 Receives reassigned benefits from 1 practitioner
Practice locations: Riverhead, NY

National Provider Directory

National Provider Directory

Locations

1200 Waters Pl
Ste M105
Bronx, NY 10461
Phone (718) 792-4500

632 Roanoke Ave
Riverhead, NY 11901
Phone (631) 208-8270

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1902560964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012728",
            "telephone_number": "631-939-2127",
            "fax_number": "718-892-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012728",
            "telephone_number": "631-939-2127",
            "fax_number": "718-892-0736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Tyler Dr",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119015022",
            "country_code": "US",
            "telephone_number": "631-939-2127",
            "fax_number": "332-330-9601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIABETES & ENDOCRINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "CHARMIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-939-2127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.