Individual provider Active NPI

Kenneth Levine

  • Anesthesiology Physician
  • Oceanside, NY
National Provider Identifier
1083677454
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
191138 Issued in NY
Practice address
2446 Washington Avenue
Oceanside, NY 11572
Phone
(516) 536-0946
Fax
(516) 536-4495
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 191138 NY Primary

Addresses

Primary practice location

2446 Washington Avenue
Oceanside, NY 11572

Mailing address

2446 Washington Avenue
Oceanside, NY 11572
Phone (516) 536-0946

Other identifiers 1

IdentifierTypeStateIssuer
01581364MedicaidNY

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
I20070219000156 NY Practitioner - Anesthesiology 3274635453 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York Downstate Medical Center, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

575 Underhill Blvd
Syosset, NY 11791-3426
Phone (516) 696-2977

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Star Suites LLC Anesthesiology CurrentSince Sep 29, 2021 Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2025 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince May 1, 2010 Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2025 Accepting new patients
Islandwide Gastroenterology PC CurrentSince Jan 1, 2012 Accepting new patients

Locations

623 Stewart Ave
Ste 101
Garden City, NY 11530
Phone (516) 222-7827

1205 Franklin Ave
Ste 150
Garden City, NY 11530
Phone (516) 222-0067

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: klevine230142@direct.optum.com

Organizations & group practices 5

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083677454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 WASHINGTON AVENUE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-536-0946",
            "fax_number": "516-536-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2446 WASHINGTON AVENUE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-536-0946",
            "fax_number": "516-536-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "191138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01581364",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.