DR. ROBERT A. SWIERUPSKI M.D.
NPI 1134143092
Internal Medicine in Saint James, NY

NPI Status: Active since July 26, 2006

Contact Information

403 LAKE AVE
SAINT JAMES, NY
ZIP 11780
Phone: (631) 862-7062
Fax: (631) 862-7114

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  • Individual
  • Male
  • Years of Experience 24
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About ROBERT SWIERUPSKI

This page provides the complete NPI Profile along with additional information for Robert Swierupski, an internist established in Saint James, New York with a medical specialization in Internal Medicine and more than 24 years of experience. He graduated from Tulane University School Of Medicine in 2002. The healthcare provider is registered in the NPI registry with number 1134143092 assigned on July 2006. The practitioner's primary taxonomy code is 207R00000X with license number 312785 (NY). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1134143092
Provider Name
DR. ROBERT A. SWIERUPSKI M.D.
Gender
Male
Entity Type
Individual
Location Address
403 LAKE AVE SAINT JAMES, NY 11780
Location Phone
(631) 862-7062
Location Fax
(631) 862-7114
Mailing Address
403 LAKE AVE SAINT JAMES, NY 11780
Mailing Phone
(631) 862-7062
Mailing Fax
(631) 862-7114
Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2002
Is Sole Proprietor?
No
Enumeration Date
07-26-2006
Last Update Date
12-17-2024
Code Navigator

An internist like Robert Swierupski is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
312785
License State
NY
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

223943 (MA)
2207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

37974 (AZ)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
93329OTHER (01)FALLON
AA34789OTHER (01)HPHC
J28722OTHER (01)MAMABC
468248OTHER (01)TUFTS
000000030457OTHER (01)BMC HEALTHNET
2102641MEDICAID (05)MA 
6594681OTHER (01)CIGNA
412722OTHER (01)RIBCHIP

Medicare Participation & PECOS Enrollment Status

Robert Swierupski is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Robert Swierupski is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6305873225

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20220812000808

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    20 DME suppliers used 46 Medicare Claims 91 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    14 DME suppliers used 22 Medicare Claims 24 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    5 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    4 DME suppliers used 16 Medicare Claims 16 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    4 DME suppliers used 16 Medicare Claims 36 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    6 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    6 DME suppliers used 18 Medicare Claims 96 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    1 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    1 DME suppliers used 18 Medicare Claims 18 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 12 times for 12 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 17 times for 17 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 114 times for 114 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

This service was performed 29 times for 29 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 473 times for 326 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 447 times for 311 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 216 times for 153 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 322 times for 247 patients

Cyanocobalamin (vitamin b-12) level

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

This service was performed 64 times for 51 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 37 times for 37 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 432 times for 351 patients

Ferritin (blood protein) level

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

This service was performed 43 times for 33 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 268 times for 186 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

This service was performed 13 times for 13 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 484 times for 332 patients

Iron binding capacity

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

This service was performed 42 times for 32 patients

Iron level

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

This service was performed 43 times for 33 patients

Pneumococcal vaccine, 23-valent

The 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.

This service was performed 12 times for 12 patients

Prostate cancer screening; prostate specific antigen test (psa)

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

This service was performed 34 times for 34 patients

Psa (prostate specific antigen) measurement, total

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

This service was performed 66 times for 49 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 25 times for 25 patients

Stool analysis for blood to screen for colon tumors

A stool analysis for blood is a non-invasive procedure used to check for the presence of hidden blood in your stool. This can be an early sign of colon tumors. The test involves collecting a small sample of stool at home and sending it to a lab for analysis.

This service was performed 11 times for 11 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 148 times for 99 patients

Uric acid level, blood

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

This service was performed 51 times for 35 patients

Urine microalbumin (protein) level

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

This service was performed 57 times for 52 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 179 times for 130 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $38.57 for a new patient copayment and $29.4 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 11780 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $154.28
  • Minimum New Patient Price $67.4
  • Maximum New Patient Price $203.53
  • Average New Patient Copayment $38.57
  • Minimum New Patient Copayment $16.85
  • Maximum New Patient Copayment $50.88

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $117.62
  • Minimum Established Patient Price $21.66
  • Maximum Established Patient Price $164.45
  • Average Established Patient Copayment $29.4
  • Minimum Established Patient Copayment $5.41
  • Maximum Established Patient Copayment $41.11

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Breast Cancer Screening 74% 310
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening 69% 833
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Consultation of the Prescription Drug Monitoring ProgramYesN/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Diabetes: Medical Attention for Nephropathy 93% 221
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record 100% 3347
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 85% 2576
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk 41% 776
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Health Information Exchange 19% 108
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Patient-Specific Education 0% 736
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults 87% 776
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Influenza Immunization 73% 942
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 86% 1180
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access 97% 736
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 67% 736
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of High-Risk Medications in the Elderly 10% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
776
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Robert Swierupski is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST CHARLES HOSPITAL200 BELLE TERRE ROAD
PORT JEFFERSON, NY 11777
(631) 474-6000Acute Care Hospitals
GOOD SAMARITAN HOSPITAL MEDICAL CENTER1000 MONTAUK HIGHWAY
WEST ISLIP, NY 11795
(631) 376-3000Acute Care Hospitals
ST CATHERINE OF SIENA HOSPITAL MEDICAL CENTER50 ROUTE 25A
SMITHTOWN, NY 11787
(631) 862-3000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1134143092
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2164246018
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 6 + 4 + 2 + 4 + 6 + 0 + 1 + 8 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1134143092 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1881716389O'BRIEN & THOMPSON MD PC
Organization
Specialist403 LAKE AVE
SAINT JAMES, NY 11780
(631) 862-7062
1558589044 CLARE A FARRELL NP
Individual
Nurse Practitioner (Family)403 LAKE AVE
SAINT JAMES, NY 11780
(631) 862-7062

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134143092, enumerated in the NPI registry as an "individual" on July 26, 2006

The provider is located at 403 Lake Ave Saint James, Ny 11780 and the phone number is (631) 862-7062

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 24 years of experience. He graduated from Tulane University School Of Medicine in 2002.

The provider might be accepting Accepts: Medicare, Medicaid, Tufts Health Plan and Cigna. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $154.28 with an average copayment of $38.57 for new patient appointments. Established patients should expect a typical charge of $117.62 and an average copayment of 29.4. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit, Blood test, comprehensive group of blood chemicals, Blood test, lipids (cholesterol and triglycerides), Blood test, thyroid stimulating hormone (tsh), Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count, Cyanocobalamin (vitamin b-12) level, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Ferritin (blood protein) level, Hemoglobin a1c level, Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment, Insertion of needle into vein for collection of blood sample, Iron binding capacity, Iron level, Pneumococcal vaccine, 23-valent, Prostate cancer screening; prostate specific antigen test (psa), Psa (prostate specific antigen) measurement, total, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Stool analysis for blood to screen for colon tumors, Thyroxine (thyroid chemical), free, Uric acid level, blood, Urine microalbumin (protein) level and Vitamin d-3 level.

The practitioner is affiliated to the following hospital(s): ST CHARLES HOSPITAL, GOOD SAMARITAN HOSPITAL MEDICAL CENTER and ST CATHERINE OF SIENA HOSPITAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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