Organization Active NPI

Steven J Litman MD PC

  • Interventional Pain Medicine Physician
  • Bay Shore, NY
National Provider Identifier
1083893028
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
184902 Issued in NY
Legal business name
STEVEN J LITMAN MD PC
Practice address
387 East Main Street
Ste 104
Bayshore, NY 11706
Phone
(631) 665-0075
Fax
(631) 665-4951
NPI assigned
Oct 26, 2007
Last updated
Oct 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Ms. Dore Mary Seely
Title
Office Manager
Phone
(631) 665-0075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 184902 NY Primary

Addresses

Primary practice location

387 East Main Street
Ste 104
Bayshore, NY 11706

Mailing address

387 East Main Street
Ste 104
Bayshore, NY 11706
Phone (631) 665-0075

Other identifiers 1

IdentifierTypeStateIssuer
01245812MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050802001073 NY Part B Supplier - Clinic/Group Practice 1153359948 Receives reassigned benefits from 1 practitioner
Practice locations: Port Jefferson, NY; Port Jefferson Station, NY

National Provider Directory

National Provider Directory

Locations

387 E Main St
Ste 102
Bay Shore, NY 11706
Phone (631) 665-0075

387 E Main St
Ste 104
Bay Shore, NY 11706
Phone (631) 665-0075

200 Belle Terre Rd
#110
Port Jefferson, NY 11777
Phone (631) 298-4008

5225 Nesconset Hwy
Ste 49
Port Jefferson Station, NY 11776
Phone (631) 331-7857

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1083893028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 EAST MAIN STREET",
            "address_2": "STE 104",
            "city": "BAYSHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-665-0075",
            "fax_number": "631-665-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 EAST MAIN STREET",
            "address_2": "STE 104",
            "city": "BAYSHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-665-0075",
            "fax_number": "631-665-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN J LITMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "SEELY",
        "authorized_official_first_name": "DORE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-665-0075",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "184902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01245812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.