Individual provider Active NPI

Frozan Walyzada, M.D.

  • Psychiatry Physician
  • Stony Brook, NY
National Provider Identifier
1912352972
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
300447 Issued in NY
Practice address
101 Nicholls Rd
Stony Brook, NY 11794-0001
Phone
(631) 444-6050
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 300447 NY Primary

Addresses

Primary practice location

101 Nicholls Rd
Stony Brook, NY 11794-0001

Mailing address

101 Nicholls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-6050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200117000453 NY Practitioner - Psychiatry 6103258538 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300447NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Single Specialty CurrentSince May 25, 2021 Accepting new patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Single Specialty CurrentSince Mar 7, 2025 Accepting new patients
The Long Island Home Single Specialty CurrentSince Nov 17, 2019 Accepting new patients
The Long Island Home Single Specialty CurrentSince Nov 17, 2019 Accepting new patients
Bronxcare Health System CurrentSince May 25, 2021 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

400 Sunrise Hwy
Amityville, NY 11701
Phone (631) 264-4000

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1276 Fulton Ave
Fl 5
Bronx, NY 10456
Phone (718) 466-7281

169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850

101 Nicholls Rd
Stony Brook, NY 11794
Phone (631) 444-2436

Networks

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1912352972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICHOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICHOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALYZADA",
        "first_name": "FROZAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "300447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.