Individual provider Active NPI

Alec Ebraim Vaezi, M.D., PH.D.

  • Otolaryngology Physician
  • Mineola, NY
National Provider Identifier
1154570679
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
253792 Issued in MA
Practice address
120 Mineola Blvd Ste 320
Mineola, NY 11501-4077
Phone
(516) 663-2436
Fax
(516) 663-2780
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A105098 CA
Otolaryngology Physician 207Y00000X MT183380 PA
Otolaryngology Physician 207Y00000X 301004 NY
Otolaryngology Physician 207Y00000X 253792 MA Primary

Addresses

Primary practice location

120 Mineola Blvd Ste 320
Mineola, NY 11501-4077

Mailing address

120 Mineola Blvd Ste 320
Mineola, NY 11501-4077
Phone (516) 663-2436

Other identifiers 2

IdentifierTypeStateIssuer
05858562MedicaidNY
110095099AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avaezi319152@nyumc.direct-ci.com Direct

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
I20191011002045 NY Practitioner - Otolaryngology 7618027764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1300 Franklin Ave
Suite Ul3Aandb
Garden City, NY 11530-1886
Phone (516) 747-8900

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion13
Laminectomy or laminotomy (partial removal of spine bones)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11
Melanoma (skin cancer) excision46
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A105098CAMDOtolaryngology Physician
253792MAMDOtolaryngology Physician
MT183380PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Otolaryngology CurrentSince Oct 1, 2019 Accepting new patients
New York University CurrentSince Oct 1, 2019 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

120 Mineola Blvd
Ste 320
Mineola, NY 11501
Phone (516) 663-3300

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

889 E Main St
Ste 308
Riverhead, NY 11901
Phone (631) 386-3500

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: avaezi319152@nyumc.direct-ci.com
  • Direct secure messaging: avaezi1262616@nychhc.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1154570679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD STE 320",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014077",
            "telephone_number": "516-663-2436",
            "fax_number": "516-663-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD STE 320",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014077",
            "telephone_number": "516-663-2436",
            "fax_number": "516-663-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAEZI",
        "first_name": "ALEC",
        "middle_name": "EBRAIM",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A105098",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MT183380",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "301004",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "253792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05858562",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110095099A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avaezi319152@nyumc.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 Mineola Blvd Ste 320",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.