Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew John Pergamo

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1265967780

Matthew John Pergamo is a Vascular Surgery in Stony Brook, New York. Qualified in 2017, 9 years ago. Practices with Stony Brook Surgical Associates University Faculty Practice Corporati, a 102-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

101 Nicolls Rd
Stony Brook, NY 11794-6402
Phone: (631) 689-8333
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 317843 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1265967780
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 21, 2017
Last updated in NPPESAugust 26, 2024
Certification dateAugust 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyVASCULAR SURGERY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Stony Brook Surgical Associates University Faculty Practice Corporati — 102 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Stony Brook