Individual provider Active NPI

Maureen M. Orsen, MD

  • Internal Medicine Physician
  • Kings Park, NY
National Provider Identifier
1154492429
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
129589 Issued in NY
Practice address
395 Sunken Meadow Road
Kings Park, NY 11754
Phone
(631) 269-5800
Fax
(631) 269-5876
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 129589-1 NY
Internal Medicine Physician 207R00000X 129589 NY Primary

Addresses

Primary practice location

395 Sunken Meadow Road
Kings Park, NY 11754

Mailing address

395 Sunken Meadow Road
Kings Park, NY 11754
Phone (631) 269-5800

Other identifiers 1

IdentifierTypeStateIssuer
00774658MedicaidNY

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
I20100908000717 NY Practitioner - Internal Medicine 4183749583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129589-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johnland Nursing Center, Inc. Internal Medicine CurrentSince Jan 1, 1992 Accepting new patients
St. Johnland Nursing Center, Inc. CurrentSince Jan 1, 1992 Accepting new patients
North Shore-Lij Medical PC Internal Medicine Past Accepting new patients
Huntington Hospital Dolan Family Health Center PastSince Jun 7, 2024 Accepting new patients

Locations

395 Sunken Meadow Rd
Kings Park, NY 11754
Phone (631) 269-5800

Organizations & group practices 4

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1154492429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW ROAD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-269-5800",
            "fax_number": "631-269-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW ROAD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-269-5800",
            "fax_number": "631-269-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORSEN",
        "first_name": "MAUREEN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "129589-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "129589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00774658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

Verify at the official NPI Registry.