NPIMap

Individual provider Active NPI

Isadora C Botwinick, M.D.

  • Surgical Critical Care Physician
  • Stony Brook, NY
National Provider Identifier
1942596762
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
284543 Issued in NY
Practice address
HSC Level 19 Room 068
Stony Brook, NY 11794
Phone
(631) 444-2034
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 284543 NY Primary

Addresses

Primary practice location

HSC Level 19 Room 068
Stony Brook, NY 11794

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-2034

Other practice location 1

5700 Arlington Ave
11M
Bronx, NY 10471
Phone (917) 969-4730

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL isadora.botwinick@stonybrookmedicine.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031001886 NY Practitioner - General Surgery 1951696285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284543NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 25, 2017 Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Oct 1, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 25, 2017 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

900 Northern Blvd
Great Neck, NY 11021
Phone (516) 482-1100

4 Smith Haven Mall
Ste 200
Lake Grove, NY 11755
Phone (631) 444-4121

1999 Marcus Ave
Ste 101
New Hyde Park, NY 11042
Phone (516) 233-3601

300 Community Dr
Plandome, NY 11030

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

222 E Middle Country Rd
Ste 209
Smithtown, NY 11787
Phone (631) 638-0800

100 Nicolls Rd
Ste 209
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: isadora.botwinick@direct.stonybrookmedicine.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1942596762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC LEVEL 19 ROOM 068",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Arlington Ave",
            "address_2": "11M",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10471",
            "country_code": "US",
            "telephone_number": "917-969-4730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTWINICK",
        "first_name": "ISADORA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "284543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "isadora.botwinick@stonybrookmedicine.edu",
            "affiliation": "N",
            "address_1": "Hsc Level 19 Room 068",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.