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

Nisha Manoj Ghayalod, MD

Individual provider Addiction Medicine (Family Medicine) Physician · NPI 1790361392

Nisha Manoj Ghayalod, MD is a Family Practice in Southold, New York. Qualified in 2021, 5 years ago. Practices with Stony Brook Family and Preventive Medicine, University Faculty Practic, a 43-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
5
Licensed in
MA
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

44360 County Road 48
Southold, NY 11971-5033
Phone: (631) 734-8742
Show map & directions

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

Additional practice locations (1)

  • 905 E Main St, Riverhead, NY 11901-2613 — (934) 213-4035

Specialties & licences

Addiction Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0401X · Licence 1017323 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790361392
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 23, 2021
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Also practisesADDICTION MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Stony Brook Family And Preventive Medicine, University Faculty Practic — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare