Organization Active NPI

Syosset Endocrinology PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Syosset, NY
National Provider Identifier
1093076606
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
239938 Issued in NY
Legal business name
SYOSSET ENDOCRINOLOGY PC
Practice address
175 Jericho Tpke
Suite 204
Syosset, NY 11791-4532
Phone
(631) 271-9151
NPI assigned
May 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Alla Khalfin, M.D.NPI 1528259843
Title
Owner
Phone
(631) 271-9151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 239938 NY Primary

Addresses

Primary practice location

175 Jericho Tpke
Suite 204
Syosset, NY 11791-4532

Mailing address

175 Jericho Tpke Ste 201
Syosset, NY 11791-4538
Phone (631) 271-9151

Other identifiers 1

IdentifierTypeStateIssuer
239938OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120619000158 NY Part B Supplier - Clinic/Group Practice 6709040918 Receives reassigned benefits from 1 practitioner
Practice locations: Syosset, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2345032Syosset Endocrinology PC175 Jericho Turnpike Suite 201, Syosset, NY 11791Certificate of waiverJun 3, 2028

National Provider Directory

National Provider Directory

Locations

175 Jericho Tpke
Ste 201
Syosset, NY 11791
Phone (516) 433-9141

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1093076606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPKE STE 201",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914538",
            "telephone_number": "631-271-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPKE",
            "address_2": "SUITE 204",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914532",
            "telephone_number": "631-271-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYOSSET ENDOCRINOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "KHALFIN",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-271-9151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "239938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "239938",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.