Individual provider Active NPI

Gary Alan Levitt, RN

  • Registered Nurse
  • Lindenhurst, NY
National Provider Identifier
1043469117
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
533606 Issued in NY
Practice address
109 Riviera Pkwy
Lindenhurst, NY 11757-6116
Phone
(631) 412-5512
NPI assigned
Sep 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 031276 NY
Registered Nurse 163W00000X 533606 NY Primary

Addresses

Primary practice location

109 Riviera Pkwy
Lindenhurst, NY 11757-6116

Mailing address

1003 Dolphin LN
Holbrook, NY 11741-6209
Phone (631) 327-9753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
533606NYMDRegistered Nurse
031276NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1043469117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 DOLPHIN LN",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117416209",
            "telephone_number": "631-327-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 RIVIERA PKWY",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117576116",
            "telephone_number": "631-412-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVITT",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "031276",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "533606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.