Individual provider Active NPI

Dana M Amodeo, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Commack, NY
National Provider Identifier
1932396124
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
135 Wicks Rd
Commack, NY 11725-4420
Phone
(516) 428-2787
NPI assigned
Oct 1, 2007
Last updated
Aug 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Emergency Medicine Physician 207P00000X 252523-1 NY

Addresses

Primary practice location

135 Wicks Rd
Commack, NY 11725-4420

Mailing address

135 Wicks Rd
Commack, NY 11725-4420
Phone (516) 428-2787

Other names 1

  • Dr. Dana M Amodeo Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252523-1NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Emergency Medical Services, PC Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
Siena Emergency Medical Services, P.C. Emergency Medicine CurrentSince Jun 1, 2015 Accepting new patients
Island Emergency Medical Services, P.C. Emergency Medicine CurrentSince May 7, 2021 Accepting new patients
Port Emergency Medical Services, P.C. Emergency Medicine CurrentSince Jun 1, 2015 Accepting new patients

Locations

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

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.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1932396124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WICKS RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254420",
            "telephone_number": "516-428-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WICKS RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254420",
            "telephone_number": "516-428-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMODEO",
        "first_name": "DANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "252523-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "AMODEO",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.