MYRTA ISABEL OLIVERA DUBON MD
NPI 1184376642
Family Medicine in Bay Shore, NY
About Myrta Isabel Olivera Dubon Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MYRTA ISABEL OLIVERA DUBON MD (NPI 1184376642) is an individual family medicine provider in Bay Shore, New York, licensed in New York (338825) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Myrta Isabel Olivera Dubon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Myrta Olivera Dubon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Port Jefferson Station, NY 11776
- Reassigned Medicare billing, New York enrollment
- 636 clinicians in this Medicare group
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 11706 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Myrta Olivera Dubon's NPI number?
The NPI number for Myrta Olivera Dubon is 1184376642. It was assigned to this individual provider in the NPPES registry on January 25, 2022.
Where is Myrta Olivera Dubon located?
Myrta Olivera Dubon practices at 1377 5th Ave, Bay Shore, NY 11706. The listed phone number is (631) 758-7003.
What is Myrta Olivera Dubon's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Myrta Olivera Dubon enrolled in Medicare?
Yes. Myrta Olivera Dubon is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Myrta Olivera Dubon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Myrta Olivera Dubon reassigns Medicare benefits to North Shore Hematology Oncology Associates PC (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 Myrta Olivera Dubon'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 Myrta Olivera Dubon was last updated on August 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Myrta Isabel Olivera Dubon, MD · NPI 1184376642
Family Medicine physician in Bay Shore, New York. Individual provider, active in the CMS NPPES registry since January 25, 2022.
## Identity
- **NPI:** 1184376642 (Entity type: Individual)
- **Enumerated:** January 25, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 338825 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1377 5TH AVE, Bay Shore, NY 11706-4131
- **Phone:** (631) 758-7003
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** North Shore Hematology Oncology Associates PC (NPI 1396794574, Port Jefferson Station, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** August 28, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1184376642) · Data from the CMS NPPES public registry.