Individual provider Active NPI

Allamprabhu Sahebgouda Patil, MD

  • Neurology Physician
  • Melville, NY
National Provider Identifier
1114019700
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
179697 Issued in NY
Practice address
1 Country Meadow CT
Melville, NY 11747-2026
Phone
(631) 367-6427
Fax
(631) 367-6234
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 179697 NY
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 179697 NY
Vascular Neurology Physician 2084V0102X 179697 NY
Neurology Physician 2084N0400X 179697 NY Primary
Neurocritical Care Physician 2084A2900X 179697 NY
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X 179697 NY
Epilepsy Physician 2084E0001X 179697 NY

Addresses

Primary practice location

1 Country Meadow CT
Melville, NY 11747-2026

Mailing address

1 Country Meadow CT
Melville, NY 11747-2026
Phone (516) 586-6330

Other identifiers 1

IdentifierTypeStateIssuer
01277430MedicaidNY

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
I20070515000608 NY Practitioner - NeurologyPractitioner - NeurosurgeryPractitioner - Critical Care (Intensivists) 0042317620 Reassigns benefits to 3 organizations
Practice locations: Jackson Heights, NY; Manhasset, NY; Melville, NY

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Critical Care (Intensivists), Neurosurgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179697NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TJH Medical Services, P.C. Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Patil Neurology and Neurodiagnostics P.C. Neurology Current Accepting new patients
Allamprabhu Patil MD PC Neurology Current Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Mar 15, 2017 Accepting new patients
Integral Neurodiagnostic PC Neurology Current Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Neurology CurrentSince Jul 1, 2016 Accepting new patients
North Shore Long Island Jewish Healthcare Internal Medicine Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

100 Community Dr
Great Neck, NY 11021
Phone (516) 365-1805

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: allamprabhupatil@nslijmedgr.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1114019700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COUNTRY MEADOW CT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472026",
            "telephone_number": "516-586-6330",
            "fax_number": "516-586-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COUNTRY MEADOW CT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472026",
            "telephone_number": "631-367-6427",
            "fax_number": "631-367-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "ALLAMPRABHU",
        "middle_name": "SAHEBGOUDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NY",
            "license": "179697",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NY",
            "license": "179697",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NY",
            "license": "179697",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "179697",
            "primary": true
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "NY",
            "license": "179697",
            "primary": false
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "NY",
            "license": "179697",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "NY",
            "license": "179697",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01277430",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.