Integrative Medicine of Brookhaven P.C.
NPI 1336647213ActiveOrganization· Family Medicine· Port Jefferson Station, NY
Family Medicine in Port Jefferson Station, New York, registered in NPPES in January 2018. The authorized official on file is Dimos G. Kanakoudas, MD, Owner/Medical Director.
Overview
| NPI | 1336647213 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 25, 2018 |
| Last updated in NPPES | Mar 14, 2021 |
| Certified by provider | Mar 14, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 257261 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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