Individual provider Active NPI

Theresa Ann Dragottto, L.AC.

  • Acupuncturist
  • Smithtown, NY
National Provider Identifier
1962659961
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
002284 Issued in NY
Practice address
363 Route 111
Smithtown, NY 11787-4756
Phone
(631) 833-9996
Fax
(631) 382-4082
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 002284 NY Primary

Addresses

Primary practice location

363 Route 111
Smithtown, NY 11787-4756

Mailing address

4 Stone Gate CT
Smithtown, NY 11787-1567
Phone (631) 833-9996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002284NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Acupuncture of Long Island Acupuncturist CurrentSince Feb 6, 2022 Accepting new patients

Locations

363 Route 111
Ste LL5
Smithtown, NY 11787
Phone (631) 656-0828

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1962659961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 STONE GATE CT",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871567",
            "telephone_number": "631-833-9996",
            "fax_number": "631-382-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-833-9996",
            "fax_number": "631-382-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGOTTTO",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "002284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.