Individual provider Active NPI

Baleigh Marie Iott, PA

  • Physician Assistant
  • Stony Brook, NY
National Provider Identifier
1962171629
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027250 Issued in NY
Practice address
100 Nicolls Rd RM 80
Stony Brook, NY 11794-2821
Phone
(631) 444-1116
Fax
(631) 444-1535
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027250 NY Primary

Addresses

Primary practice location

100 Nicolls Rd RM 80
Stony Brook, NY 11794-2821

Mailing address

31 Surrey Dr
Center Moriches, NY 11934-2821
Phone (517) 879-8915

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929001635 NY Practitioner - Physician Assistant 5597162859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

101 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027250NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients

Locations

100 Nicolls Rd
Rm 80
Stony Brook, NY 11794
Phone (631) 444-3429

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: baleigh.iott@direct.stonybrookmedicine.edu

Organizations & group practices 2

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1962171629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SURREY DR",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119342821",
            "telephone_number": "517-879-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD RM 80",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117942821",
            "telephone_number": "631-444-1116",
            "fax_number": "631-444-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOTT",
        "first_name": "BALEIGH",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.