NPIMap

Individual provider Active NPI

Bicky Vettichira, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Stony Brook, NY
National Provider Identifier
1992115398
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Dept of Medicine HSC Level 16
Suny Stony Brook
Stony Brook, NY 11794-0001
Phone
(631) 444-7411
Fax
(631) 444-2493
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Dept of Medicine HSC Level 16
Suny Stony Brook
Stony Brook, NY 11794-0001

Mailing address

Stony Brook Teaching Hospital
Deptartment of Medicine PO Box 1508
Stony Brook, NY 11794-8430
Phone (631) 444-8231

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
I20200925001525 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8729316161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

415 Northern Blvd
Great Neck, NY 11021-4812
Phone (516) 829-2273

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304063NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Aug 1, 2022 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Summit Health CurrentSince Aug 1, 2020 Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

24818 Union Tpke
Bellerose, NY 11426
Phone (718) 300-3368

19303 Union Tpke
Fresh Meadows, NY 11366
Phone (516) 721-4648

415 Northern Blvd
Great Neck, NY 11021
Phone (201) 684-1633

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

2035 Lakeville Rd
North New Hyde Pk, NY 11040
Phone (516) 328-9797

Networks

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

Interoperability endpoints

  • Direct secure messaging: bicky.vettichira.1@2983.direct.athenahealth.com

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 10

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1992115398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK TEACHING HOSPITAL",
            "address_2": "DEPTARTMENT OF MEDICINE PO BOX 1508",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948430",
            "telephone_number": "631-444-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT OF MEDICINE HSC LEVEL 16",
            "address_2": "SUNY STONY BROOK",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-7411",
            "fax_number": "631-444-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTICHIRA",
        "first_name": "BICKY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-07-17",
        "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": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.