Individual provider Active NPI

Mohamed El-Ounsi, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Deer Park, NY
National Provider Identifier
1053761254
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
060246 Issued in NY
Practice address
1992 Deer Park Ave Ste 1
Deer Park, NY 11729-2729
Phone
(631) 667-0004
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 04614 NH
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN1858814 MA
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 060246 NY Primary

Addresses

Primary practice location

1992 Deer Park Ave Ste 1
Deer Park, NY 11729-2729

Mailing address

1992 Deer Park Ave Ste 1
Deer Park, NY 11729-2729
Phone (631) 667-0004

Other practice location 1

550 first ave
NYU Langone Medical Center
New York, NY 10016-9196
Phone (212) 263-5506

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
I20231207001678 NY Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 7719336387 Practice locations: Deer Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
New York University College of Dentistry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1992 Deer Park Ave
Suite 1
Deer Park, NY 11729-2729
Phone (631) 667-0004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1858814MAMDOral and Maxillofacial Surgery (Dentist)
04614NHMDOral and Maxillofacial Surgery (Dentist)
060246NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery CurrentSince Jun 2, 2023 Accepting new patients

Locations

1992 Deer Park Ave
Ste 1
Deer Park, NY 11729
Phone (631) 667-0004

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1053761254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 DEER PARK AVE STE 1",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292729",
            "telephone_number": "631-667-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1992 DEER PARK AVE STE 1",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292729",
            "telephone_number": "631-667-0004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 first ave",
            "address_2": "NYU Langone Medical Center",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EL-OUNSI",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NH",
            "license": "04614",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1858814",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "060246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

Verify at the official NPI Registry.