Demetrius Daniel Felipe Mazidis, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

450 Clarkson Ave
Brooklyn, NY 11203-2012

Phone

(718) 270-1000

NPI assigned

Jun 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John T Mather Memorial HospitalGroup PAC ID 1254237753, shared by 6 NPIs, 176 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

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

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.

• John T. Mather Memorial Hospital

  • Psychiatry Physician
  • Port Jefferson Station, NY
  • NPI 1376642371
  Medicare reassignment NPD
• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  Medicare reassignment NPD
• John T. Mather Memorial Hospital

  • Hospitalist Physician
  • Port Jefferson, NY
  • NPI 1932296316
  NPD
• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation

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

{
    "created_epoch": "1623542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1952979387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 76TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282318",
            "telephone_number": "516-924-6854",
            "fax_number": "484-255-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZIDIS",
        "first_name": "DEMETRIUS",
        "middle_name": "DANIEL FELIPE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-13",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mazal Diagnostics LLC
• Mazal Physical Therapy P.C.
• Mislie Mazama
• Mauricio Mazatan Fernandez
• Kaukab Mazhar
• Martha T Mazier, MS CCC-SLP
• Jessica Mazile, PA
• Samuil Mazler, RPH
• Lev Mazniker, O.D.
• Bianca Mazor

• Student in an Organized Health Care Education/Training Program in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.