Individual provider Active NPI

Patina Lui, M.D.

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1033504352
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
298072 Issued in NY
Practice address
568 Broadway RM 304
New York, NY 10012-3271
Phone
(212) 966-7600
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 298072 NY Primary

Addresses

Primary practice location

568 Broadway RM 304
New York, NY 10012-3271

Mailing address

1000 10TH Ave
Suite 10C
New York, NY 10019-1147
Phone (212) 523-8366

Other practice location 1

1000 10th Ave
Suite 10C
New York, NY 10019-1147
Phone (212) 523-8366

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
I20250508002885 NY Practitioner - Obstetrics/Gynecology 7719223932 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Square Care Medical Group, LLP Obstetrics & Gynecology CurrentSince Apr 30, 2025 Accepting new patients

Locations

285 Sills Rd
Ste D
East Patchogue, NY 11772
Phone (631) 438-0777

191 Herricks Rd
New Hyde Park, NY 11040
Phone (516) 248-0144

568 Broadway
Rm 404
New York, NY 10012
Phone (212) 966-7600

568 Broadway
Rm 304
New York, NY 10012
Phone (212) 966-7600

Interoperability endpoints

  • Direct secure messaging: patina.lui.1@15987.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15987/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1033504352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "address_2": "SUITE 10C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-8366",
            "fax_number": "212-523-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 BROADWAY RM 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123271",
            "telephone_number": "212-966-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_2": "Suite 10C",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-8366",
            "fax_number": "212-523-8066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUI",
        "first_name": "PATINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "298072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.