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DENISE DRISCOLL
NPI 1164575080
Nurse Practitioner - Psychiatric/Mental Health in Port Jefferson, NY

Active since January 22, 2007PECOS Enrolled
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 473-1320(631) 473-3091 Get Directions Write a Review

NPPES record last updated: April 30, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Denise Driscoll NPPES

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

DENISE DRISCOLL (NPI 1164575080) is an individual psychiatric/mental health provider in Port Jefferson, New York, licensed in New York (F400242-1) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164575080
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDENISE DRISCOLL
Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2119
Mailing Address625 Belle Terre Rd, Suite 100Port Jefferson, NY 11777-2316 · (631) 473-1320 · Fax (631) 473-3091
Phone(631) 473-1320
Fax(631) 473-3091
Sole ProprietorNo
Enumeration DateJanuary 22, 2007
Last NPPES UpdateApril 30, 2015
✔ NPI 1164575080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · F400242-1
75 N COUNTRY RD, Port Jefferson, NY 11777
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Other Identifiers 2

Medicare UPINP12862NY
Medicare UPIN96N241NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Denise Driscoll 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.

Medicare Billing Reassignment

Medicare enrollment records show Denise Driscoll reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

John T. Mather Memorial Hospital
Same address
Psychiatry
75 N COUNTRY RD
Port Jefferson Station, NY 11777
  • Reassigned Medicare billing, New York enrollment
  • Also billed through NPI 1467249334 (New York)
  • 232 clinicians in this Medicare group
NPI 1376642371 (631) 473-1320

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11777 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.

JUSTINA CATHERINE MELLONE DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
AAKAASH VARMA MD
Dermatology
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KRISELA VOJNIKU MD
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
LORETTA DIDWELL
Physician Assistant
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
RAYMOND WONG
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-7654
SHEHNAZ WASIM MD
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-1443
JULIA KOROBENKO DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KATHLEEN FANELLI
Nurse Practitioner (Acute Care)
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Denise Driscoll's NPI number?

The NPI number for Denise Driscoll is 1164575080. It was assigned to this individual provider in the NPPES registry on January 22, 2007.

Where is Denise Driscoll located?

Denise Driscoll practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.

What is Denise Driscoll's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Denise Driscoll enrolled in Medicare?

Yes. Denise Driscoll is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Denise Driscoll's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Denise Driscoll reassigns Medicare benefits to John T. Mather Memorial Hospital (Port Jefferson Station, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Denise Driscoll's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Denise Driscoll was last updated on April 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.