Individual provider Active NPI

Roberto G Colangelo, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Roslyn, NY
National Provider Identifier
1164514998
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
192051 Issued in NY
Practice address
100 Port Washington Blvd
Roslyn, NY 11576
Phone
(516) 365-8372
Fax
(516) 390-7326
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 192051 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Roslyn, NY 11576

Mailing address

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 365-8372

Other identifiers 1

IdentifierTypeStateIssuer
01768905MedicaidNY

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
I20080123000617 NY Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 3476635921 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Jul 6, 2020 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients

Locations

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
#107
Roslyn, NY 11576
Phone (516) 365-8372

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

100 Port Washington Blvd
Ste 107
Roslyn, NY 11576
Phone (516) 365-8372

100 Port Washington Blvd
#1
Roslyn, NY 11576
Phone (516) 365-8372

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1164514998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-365-8372",
            "fax_number": "516-390-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-365-8372",
            "fax_number": "516-390-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLANGELO",
        "first_name": "ROBERTO",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "192051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01768905",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.