Individual provider Active NPI

Jonathan Levitsky, MD

  • Anesthesiology Physician
  • Southampton, NY
National Provider Identifier
1023046539
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
172393 Issued in NY
Practice address
265 Herrick Rd
Southampton, NY 11968-5045
Phone
(631) 726-8350
Fax
(631) 726-8519
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 172393 NY Primary

Addresses

Primary practice location

265 Herrick Rd
Southampton, NY 11968-5045

Mailing address

PO Box 7025
Amagansett, NY 11930-7025
Phone (888) 877-3850

Other identifiers 1

IdentifierTypeStateIssuer
01355288MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060912000358 NY Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 6901850692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
State University of New York Downstate Medical Center, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8480
Phone (631) 444-2975

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794-0001
Phone (631) 638-0800

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Forks Medical PC Anesthesiology CurrentSince Jul 28, 2011 Accepting new patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Anesthesiology CurrentSince Sep 1, 2022 Accepting new patients
Advanced Office Anesthesiology Consultants PLLC Anesthesiology Past Accepting new patients
East End Pain Management, LLC Past Accepting new patients

Locations

332 W Montauk Hwy
Ste 1
Hampton Bays, NY 11946
Phone (631) 723-0600

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1023046539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7025",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119307025",
            "telephone_number": "888-877-3850",
            "fax_number": "631-329-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 HERRICK RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685045",
            "telephone_number": "631-726-8350",
            "fax_number": "631-726-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVITSKY",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "172393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01355288",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.