Organization Active NPI

Amityville Pulmonology PLLC

  • Pulmonary Disease Physician
  • Amityville, NY
National Provider Identifier
1154423622
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
AMITYVILLE PULMONOLOGY PLLC
Practice address
317 Broadway Ste a
Amityville, NY 11701-2709
Phone
(631) 598-5864
Fax
(631) 598-5866
NPI assigned
Sep 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Authorized official

Name
Dr. Vinod Khanijo, MD
Title
Owner
Phone
(631) 598-5864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

317 Broadway Ste a
Amityville, NY 11701-2709

Mailing address

317 Broadway Ste a
Amityville, NY 11701-2709
Phone (631) 598-5864

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060410000225 NY Part B Supplier - Clinic/Group Practice 2567471139 Receives reassigned benefits from 18 practitioners
Practice locations: West Islip, NY; Woodbury, NY; Patchogue, NY; Oakdale, NY; East Islip, NY; Bethpage, NY; Amityville, NY

National Provider Directory

National Provider Directory

Locations

317 Broadway
Ste A
Amityville, NY 11701
Phone (631) 598-5864

546 Montauk Hwy
West Islip, NY 11795
Phone (631) 598-5864

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1154423622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 BROADWAY STE A",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012709",
            "telephone_number": "631-598-5864",
            "fax_number": "631-598-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 BROADWAY STE A",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012709",
            "telephone_number": "631-598-5864",
            "fax_number": "631-598-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMITYVILLE PULMONOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-03",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "KHANIJO",
        "authorized_official_first_name": "VINOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-598-5864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.