Active NPI
North Shore Infectious Diseases Consultants, PC
- Infectious Disease Physician
- Greenvale, NY
National Provider Identifier
1114974094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- Legal business name
- NORTH SHORE INFECTIOUS DISEASES CONSULTANTS, PC
- Practice address
- 2200 Northern Blvd Ste 205
Greenvale, NY 11548-1220 - Phone
- (516) 767-7771
- Fax
- (516) 767-7765
- NPI assigned
- May 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angie Rodriguez
- Title
- Practice Administrator
- Phone
- (516) 767-7771
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | Primary |
Addresses
Primary practice location
2200 Northern Blvd Ste 205
Greenvale, NY 11548-1220
Mailing address
2200 Northern Blvd Ste 205
Greenvale, NY 11548-1220
Phone (516) 767-7771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01175960 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
44 S Bayles Ave
#216
Port Washington, NY 11050
Phone (516) 767-7771
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Infectious Disease Physician
- Roslyn, NY
- NPI 1700836608
-
- Infectious Disease Physician
- New York, NY
- NPI 1710933395
-
- Infectious Disease Physician
- Sea Cliff, NY
- NPI 1972542546
-
- Infectious Disease Physician
- East Stroudsburg, PA
- NPI 1083663694
-
- Infectious Disease Physician
- Pomona, CA
- NPI 1861441594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712275200000",
"number": "1114974094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 NORTHERN BLVD STE 205",
"city": "GREENVALE",
"state": "NY",
"postal_code": "115481220",
"telephone_number": "516-767-7771",
"fax_number": "516-767-7765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 NORTHERN BLVD STE 205",
"city": "GREENVALE",
"state": "NY",
"postal_code": "115481220",
"telephone_number": "516-767-7771",
"fax_number": "516-767-7765"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH SHORE INFECTIOUS DISEASES CONSULTANTS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-27",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A",
"authorized_official_last_name": "RODRIGUEZ",
"authorized_official_first_name": "ANGIE",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "516-767-7771"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01175960",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenvale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.