| Nastassia De Souza, MD | |
|
515 Bellport Ave, Bellport, NY 11713-1711 | |
| (631) 288-7120 | |
| (929) 455-9423 |
| Full Name | Nastassia De Souza |
|---|---|
| Gender | Female |
| Speciality | Endocrinology |
| Experience | 12 Years |
| Location | 515 Bellport Ave, Bellport, New York |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891178836 | NPI | - | NPPES |
| 103292986 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MT209620 (Pennsylvania) | Secondary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 323186 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Long Island Community Hospital | Patchogue, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| New York University | 1355232422 | 5027 |
| Entity Name | New York University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285826438 PECOS PAC ID: 1355232422 Enrollment ID: O20081202000185 |
| Entity Name | New York University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285826438 PECOS PAC ID: 1355232422 Enrollment ID: O20090822000026 |
| Mailing Address | Practice Location Address |
|---|---|
| Nastassia De Souza, MD 515 Bellport Ave, Bellport, NY 11713-1711 Ph: (631) 288-7120 | Nastassia De Souza, MD 515 Bellport Ave, Bellport, NY 11713-1711 Ph: (631) 288-7120 |
Anthonette Rosemarie Desire, M.D. Endocrinology, Diabetes & Metabolism 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. Endocrinology, Diabetes & Metabolism Medicare: Not Enrolled in Medicare Practice Location: 926 S Country Rd, Bellport, NY 11713 Phone: 631-286-6130 Fax: 631-286-6130 | |
Dr. Nathanael Desire, D.O. Endocrinology, Diabetes & Metabolism Medicare: Accepting Medicare Assignments Practice Location: 1 Station Ct, Bldg A Suite 1, Bellport, NY 11713 Phone: 631-803-8247 Fax: 631-803-8251 |