DR. NICHOLAS DIVARIS (NPI# 1023065380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023065380 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS DIVARIS |
| Practice Address |
14 Technology Dr East Setauket NY 11733-3472 |
| Mailing Address |
Po Box 1559 Stony Brook NY 11790-0989 |
| Practice Telephone | 6314444233 |
| Mailing Telephone | 6314444233 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
207388 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | AETNA | 7470302 | 01 |
| NY | EMPIRE BC.BS | 421G01 | 01 |
| NY | 02176736 | 05 |
| Street Address |
14 TECHNOLOGY DR |
| City | EAST SETAUKET |
| State | NY |
| Zip Code | 11733-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497756324 | Jeffrey S Muhlrad | Orthopaedic Surgery | 14 Technology Dr, Suite 11, East Setauket, NY 11733-4047 | 2005-08-02 |
| 1518504265 | Maureen O'rourke | Physical Therapist | 14 Technology Dr, East Setauket, NY 11733-3472 | 2019-12-02 |
| 1295290013 | Arielle Demarco | Physician Assistant | 14 Technology Dr, East Setauket, NY 11733-3472 | 2019-02-06 |
| 1891277059 | Agnieszka Kapelanski | Registered Nurse | 14 Technology Dr, East Setauket, NY 11733-3472 | 2018-09-04 |
| 1053719740 | Maria Joana Rizza Relevo Rosas | Physician Assistant | 14 Technology Dr, Suite 11, 12, 15, East Setauket, NY 11733-3472 | 2014-12-11 |
| 1568891547 | Kristen Moran | Physician Assistant | 14 Technology Dr, Suite 11, East Setauket, NY 11733-3472 | 2013-11-11 |
| 1578814232 | Kristina Zhang | Specialist/Technologist | 14 Technology Dr, Suite 11, East Setauket, NY 11733-3472 | 2012-09-20 |
| 1518259225 | Mohammed Umar | General Practice | 14 Technology Dr, Suite 12, East Setauket, NY 11733-3472 | 2011-05-12 |
| 1063729689 | Nardeen Mickail | Internal Medicine | 14 Technology Dr, Suite 10, East Setauket, NY 11733-3472 | 2010-09-02 |
| 1205151768 | Megan Carroll Paulus | Orthopaedic Surgery | 14 Technology Dr, Suite 11, East Setauket, NY 11733-3472 | 2010-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063033991 | Olivia Carlino | Registered Nurse | 28 Buckingham Meadow Road, Setauket, NY 11733 | 2020-05-01 |
| 1295392553 | Johnny Slade | Emergency Medicine | 11 Bridge Rd, East Setauket, NY 11733 | 2019-05-22 |
| 1275060345 | Donna M Sweeney | Specialist | 14 Research Way East, East Setauket, NY 11733 | 2017-05-18 |
| 1659806388 | Erin Kunz | Podiatrist | Stony Brook Surgical Associates, 37 Research Way, Setauket- East Setauket, NY 11733 | 2017-05-01 |
| 1285180521 | Allison M Pinard | Specialist/Technologist | 149 Old Field Road, Setauket, NY 11733 | 2016-08-28 |
| 1578915096 | Kristyn Matovich | Behavioral Analyst | 5 Kenwood Street, East Setauket, NY 11733 | 2016-07-08 |
| 1306258900 | Patricia M. Ferrara | Licensed Practical Nurse | 181 N Bellemeade Rd, Setauket, NY 11733 | 2014-05-30 |
| 1871922898 | Island Concierge Medical Services Pllc | Internal Medicine | 3400 Nesconset Hwy. Suite 103, East Setauket, NY 11733 | 2013-11-12 |
| 1669718219 | Sheila Marie Vergith | Physician Assistant | 17 Coraway Road, Setauket, NY 11733 | 2012-12-28 |
| 1285980474 | Jennifer L Monastero | Physical Therapist | 12 Technology Dr., Unit 2, E. Setauket, NY 11733 | 2012-07-25 |
| Find all providers in zip 11733 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881128882 | Natalie Rollick | Orthopaedic Surgery | 535 East 60th Street, Hospital for Special Surgery, New York, NY 10021 | 2017-04-17 |
| 1245506245 | Jeremy Podolnick | Orthopaedic Surgery | 5 E 98th St Fl 9, New York, NY 10029-6501 | 2012-03-24 |
| 1063679942 | Saila Detore | Orthopaedic Surgery | 403 Deer Park Ave, Babylon, NY 11702-2356 | 2008-05-19 |
| 1871500124 | Howard M Black | Orthopaedic Surgery | 96 Court St, Plattsburgh, NY 12901-2733 | 2006-08-01 |
| 1790703965 | Brian M Mehling | Orthopaedic Surgery | 800 Montauk Hwy, West Islip, NY 11795-4919 | 2006-07-17 |
| 1467938894 | Eric Ryan Still | Orthopaedic Surgery | 525 E 68th St, New York, NY 10065-4870 | 2018-07-18 |
| 1932654282 | Orthopedic Faculty Practice | Orthopaedic Surgery | 6010 Bay Pkwy, 7th Floor, Brooklyn, NY 11204-6079 | 2016-08-16 |
| 1376943910 | Diederik Otto Verbeek | Orthopaedic Surgery | 535 E 70th St, New York, NY 10021-4823 | 2014-09-02 |
| 1356772479 | Chima Nwankwo | Orthopaedic Surgery | 263 7th Ave Ste 2b, Brooklyn, NY 11215-3693 | 2013-11-30 |
| 1386902617 | Joshua Dustin Namm | Orthopaedic Surgery | 101 Nicolls Rd, Hsc T18 Rm 080, Stony Brook, NY 11794-8181 | 2012-04-24 |
| Find all providers with the same taxonomy | ||||
| City | EAST SETAUKET |
| Zip Code | 11733 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.