| Dr Nathanael Desire, DO | |
|
1 Station Ct, Bldg A Suite 1, Bellport, NY 11713-2453 | |
| (631) 803-8247 | |
| (631) 803-8251 |
| Full Name | Dr Nathanael Desire |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 27 Years |
| Location | 1 Station Ct, Bellport, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922118652 | NPI | - | NPPES |
| 02502298 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 216602 (New York) | Primary |
| 208000000X | Pediatrics | 216602 (New York) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| East End Hospice, Inc | Westhampton beach, NY | Hospice |
| Suny/stony Brook University Hospital | Stony brook, NY | Hospital |
| St Charles Hospital | Port jefferson, NY | Hospital |
| Peconic Landing At Southold | Greenport, NY | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southwest Suffolk Medical Pc | 0244396349 | 164 |
| Stony Brook Internists University Faculty Practice Corporation | 9133019821 | 383 |
| Entity Name | Stony Brook Internists University Faculty Practice Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821035601 PECOS PAC ID: 9133019821 Enrollment ID: O20040416000248 |
| Entity Name | Southwest Suffolk Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104096049 PECOS PAC ID: 0244396349 Enrollment ID: O20090225000297 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Nathanael Desire, DO 1 Station Ct, Bldg A Suite 1, Bellport, NY 11713-2453 Ph: (631) 803-8247 | Dr Nathanael Desire, DO 1 Station Ct, Bldg A Suite 1, Bellport, NY 11713-2453 Ph: (631) 803-8247 |
Anthonette Rosemarie Desire, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1 Station Ct, Building A Suite 1, Bellport, NY 11713 Phone: 631-803-8247 Fax: 631-803-8251 | |
Dr. Richard Edward Edstrom Jr., M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 926 S Country Rd, Bellport, NY 11713 Phone: 631-286-6130 Fax: 631-286-6130 | |
Nastassia De Souza, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 515 Bellport Ave, Bellport, NY 11713 Phone: 631-288-7120 Fax: 929-455-9423 |