Daniel Thomas Ippolito, ANP
Nurse Practitioner, Adult Health in Patchogue, NY. Individual provider (NPI-1).
NPI number1730604752
StatusActive
Last updated in NPPESAug 10, 2017
Details
- NPI
- 1730604752
- Entity type
- Individual (NPI-1)
- Name
- Daniel Thomas Ippolito
- Credential
- ANP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 10, 2017
- Last updated
- Aug 10, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | 308385 | NY | Yes |
Practice location
77 Medford AvePatchogue, NY 11772-1281
Phone 631-666-3951 · Fax 631-750-1177
Mailing address
712 Main StIslip, NY 11751-3620
Phone 631-666-3951 · Fax 631-750-1177
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 31 Adult Health Nurse Practitioner providers in Patchogue · All 1,282 providers in Patchogue
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