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

Mr. Sam Tarik Mendoune I, NP

Individual provider Adult Health Nurse Practitioner · NPI 1003597469

Mr. Sam Tarik Mendoune I, NP is a Nurse Practitioner in Stony Brook, New York. Qualified in 2023, 3 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone: (631) 335-1657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F311288 (NY)

Record details

NPI number1003597469
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 28, 2023
Last updated in NPPESSeptember 18, 2023
Certification dateSeptember 17, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Stony Brook Internists University Faculty Practice Corporation — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Stony Brook