MR. SAM TARIK MENDOUNE I NP
NPI 1003597469
Nurse Practitioner - Adult Health in Stony Brook, NY

Q: What is Sam Mendoune's NPI number?

The NPI number for Sam Mendoune is 1003597469. It was assigned to this individual provider in the NPPES registry on July 28, 2023.

Q: What is Sam Mendoune's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Sam Mendoune was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 28, 2023PECOS Enrolled

101 NICOLLS RD, STONY BROOK, NY 11794(631) 335-1657 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Sam Tarik Mendoune I Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SAM TARIK MENDOUNE I NP (NPI 1003597469) is an individual adult health provider in Stony Brook, New York, licensed in New York (F311288) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003597469

Entity TypeIndividualMale

Primary Taxonomy363LA2200X

Provider Legal NameMR. SAM TARIK MENDOUNE ICredential: NP

Location Address101 NICOLLS RDStony Brook, NY 11794-0001

Mailing Address50 Marc DrRidge, NY 11961-2139 · (631) 335-1657

Phone(631) 335-1657

Sole ProprietorNo

Enumeration DateJuly 28, 2023

Last NPPES UpdateSeptember 18, 2023

NPPES CertifiedSeptember 17, 2023

✔ NPI 1003597469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · F311288

101 NICOLLS RD, Stony Brook, NY 11794

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Sam Tarik Mendoune I Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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