Individual provider Active NPI

Robert McCallion, ANP

  • Adult Health Nurse Practitioner
  • Huntington, NY
National Provider Identifier
1023188349
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3908761 Issued in NY
Practice address
175 East Main Street
Huntington, NY 11743-3399
Phone
(631) 424-3787
Fax
(631) 427-0198
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3908761 NY Primary

Addresses

Primary practice location

175 East Main Street
Huntington, NY 11743-3399

Mailing address

175 East Main Street
Huntington, NY 11743-3399
Phone (631) 424-3787

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718001654 NY Practitioner - Nurse Practitioner 8325279938 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
302335NYMDLicensed Practical Nurse
3908761NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince May 3, 2017 Accepting new patients
North Shore - Lij Medical PC CurrentSince May 3, 2017 Accepting new patients

Locations

175 E Main St
#M
Huntington, NY 11743
Phone (631) 424-3787

175 E Main St
Huntington, NY 11743
Phone (631) 424-3787

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: rmccallionanp218442@northwell.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1023188349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EAST MAIN STREET",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433399",
            "telephone_number": "631-424-3787",
            "fax_number": "631-427-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 EAST MAIN STREET",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433399",
            "telephone_number": "631-424-3787",
            "fax_number": "631-427-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLION",
        "first_name": "ROBERT",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "3908761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.