NPIMap

Organization Active NPI

South Nassau Communities Hospital

  • Cardiovascular Disease Physician
  • Oceanside, NY
National Provider Identifier
1073594800
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SOUTH NASSAU COMMUNITIES HOSPITAL
Practice address
One Healthy Way
Attn: Physician Billing
Oceanside, NY 11572
Phone
(516) 255-1616
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Mark Bogen
Title
Vice-President
Phone
(516) 632-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

One Healthy Way
Attn: Physician Billing
Oceanside, NY 11572

Mailing address

One Healthy Way
Attn: Physician Billing
Oceanside, NY 11572
Phone (516) 255-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000373 NY Part B Supplier - Clinic/Group Practice 5092607846 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hempstead, NY; Long Beach, NY; Merrick, NY; Oceanside, NY; Rockville Centre, NY; Valley Stream, NY; Baldwin, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

529 Beach 20th St
Ste 2
Far Rockaway, NY 11691

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1073594800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE HEALTHY WAY",
            "address_2": "ATTN: PHYSICIAN BILLING",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-255-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HEALTHY WAY",
            "address_2": "ATTN: PHYSICIAN BILLING",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-255-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH NASSAU COMMUNITIES HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "BOGEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "516-632-3000"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.