Individual provider Active NPI

Surinder S Sandhu, MD

  • Emergency Medicine Physician
  • Lynbrook, NY
National Provider Identifier
1154362739
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
205145 Issued in NY
Practice address
585 Merrick Rd
Lynbrook, NY 11563-2311
Phone
(516) 224-4156
Fax
(516) 224-4156
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 205145 NY Primary
Internal Medicine Physician 207R00000X 205145 NY

Addresses

Primary practice location

585 Merrick Rd
Lynbrook, NY 11563-2311

Mailing address

585 Merrick Rd
Lynbrook, NY 11563-2311
Phone (516) 224-4156

Other identifiers 1

IdentifierTypeStateIssuer
01854457MedicaidNY

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
I20040330001625 NY Practitioner - Emergency Medicine 6800888058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205145NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC Past Accepting new patients
Brookdale Hospital Medical Center Past Accepting new patients
Long Island Emergency Care PC Emergency Medicine Past Accepting new patients
Long Island College Hospital Emergency Medicine Past Accepting new patients
City Medical of Upper East Side, PLLC PastSince May 1, 2012 Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1154362739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632311",
            "telephone_number": "516-224-4156",
            "fax_number": "516-224-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632311",
            "telephone_number": "516-224-4156",
            "fax_number": "516-224-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "SURINDER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "205145",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "205145",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01854457",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

Verify at the official NPI Registry.