Individual provider Active NPI

Noci Deda, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Lake Placid, NY
National Provider Identifier
1922018282
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
232650 Issued in NY
Practice address
185 Old Military Rd
Lake Placid, NY 12946-1939
Phone
(518) 523-2464
Fax
(518) 523-1401
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 232650 NY Primary

Addresses

Primary practice location

185 Old Military Rd
Lake Placid, NY 12946-1939

Mailing address

122 Bloomingdale Ave Apt 1
Saranac Lake, NY 12983-1223
Phone (518) 523-3496

Other identifiers 2

IdentifierTypeStateIssuer
06000232650MedicaidNY
232650OtherNYSTATE LICENSE

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
I20040907001348 NY Practitioner - HospitalistPractitioner - Internal Medicine 4981670361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560

350 Parrish St
Canandaigua, NY 14424-1731
Phone (585) 396-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Frederick Ferris Thompson Hospital CurrentSince Sep 15, 2025 Accepting new patients
Health Quest Medical Practice, PC CurrentSince May 27, 2025 Accepting new patients
Southwest Suffolk Medical, P.C. CurrentSince Jan 1, 2016 Accepting new patients
Newburgh Physician Services PC CurrentSince Dec 9, 2024 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Sep 15, 2025 Accepting new patients
Southwest Suffolk Medical PC CurrentSince Jan 1, 2016 Accepting new patients
St. Joseph'S Hospital, Yonkers Past Accepting new patients

Locations

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

73 Buffalo St
Ste 100
Canandaigua, NY 14424

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

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

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

Networks

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

Interoperability endpoints

  • Direct secure messaging: ndeda581171@direct.urmc.rochester.edu

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.

Hospital & facility affiliations 3

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922018282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 BLOOMINGDALE AVE APT 1",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129831223",
            "telephone_number": "518-523-3496",
            "fax_number": "518-523-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OLD MILITARY RD",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461939",
            "telephone_number": "518-523-2464",
            "fax_number": "518-523-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDA",
        "first_name": "NOCI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "232650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06000232650",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "232650",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, NY

Sources for this page

Verify at the official NPI Registry.