Individual provider Active NPI

Keriake Semertzides, D.O.

  • Internal Medicine Physician
  • East Patchogue, NY
National Provider Identifier
1992064513
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
279138 Issued in NY
Practice address
100 Hospital Rd
Suite 203
East Patchogue, NY 11772-8809
Phone
(631) 475-6900
NPI assigned
May 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 279138 NY Primary

Addresses

Primary practice location

100 Hospital Rd
Suite 203
East Patchogue, NY 11772-8809

Mailing address

100 Hospital Rd
Suite 203
East Patchogue, NY 11772-8809
Phone (631) 475-6900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksemertzides509348@nyumc.direct-ci.com
Direct Messaging Address ksemertzides509348@nyumc.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151020000764 NY Practitioner - Internal Medicine 5294044954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

157 E Woodside Ave
Patchogue, NY 11772-1423
Phone (631) 475-1900

Hospital & facility affiliations

  • NYU Langone Home Health Care Home health agency, Garden City, NY, CCN 337187
  • Constellation Home Care Home health agency, Syosset, NY, CCN 337447
  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279138NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
New York University Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

100 Hospital Rd
Ste 217
East Patchogue, NY 11772

100 Hospital Rd
Ste 203
East Patchogue, NY 11772
Phone (631) 475-6900

9 Village Grn
Unit A
Patchogue, NY 11772
Phone (631) 227-6665

157 E Woodside Ave
Patchogue, NY 11772
Phone (631) 265-7000

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

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 12

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": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1992064513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "address_2": "SUITE 203",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728809",
            "telephone_number": "631-475-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "address_2": "SUITE 203",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728809",
            "telephone_number": "631-475-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMERTZIDES",
        "first_name": "KERIAKE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "279138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksemertzides509348@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Hospital Rd",
            "address_2": "Suite 203",
            "city": "East Patchogue",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117728809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksemertzides509348@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Hospital Rd",
            "address_2": "Suite 203",
            "city": "East Patchogue",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117728809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.