Individual provider Active NPI

Linda I. Lizogubenko, PA

  • Physician Assistant
  • New Hyde Park, NY
National Provider Identifier
1134249147
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009887 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1433
Phone
(718) 470-7270
Fax
(718) 470-0827
NPI assigned
Mar 31, 2007
Last updated
Feb 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009887 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1433

Mailing address

972 Brush Hollow Rd
Westbury, NY 11590-1740
Phone (516) 876-5555

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000005 NY Practitioner - Physician Assistant 3678535127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

683 Sunrise Hwy
Lynbrook, NY 11563-3246
Phone (516) 441-2155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009887NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij, Urgent Care, P.C. CurrentSince Mar 5, 2026 Accepting new patients
Just Kids Diagnostic and Treatment Center Inc Past Accepting new patients

Locations

683 Sunrise Hwy
Lynbrook, NY 11563
Phone (516) 441-2155

243 Merrick Rd
Rockville Centre, NY 11570
Phone (516) 537-9063

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21444/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1134249147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5555",
            "fax_number": "516-876-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "718-470-7270",
            "fax_number": "718-470-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZOGUBENKO",
        "first_name": "LINDA",
        "middle_name": "I.",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.