NPIMap

Organization Active NPI

Epic Long Island

  • Voluntary or Charitable Agency
  • East Meadow, NY
National Provider Identifier
1174563936
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
675100 Issued in NY
Legal business name
EPIC LONG ISLAND
Practice address
1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone
(516) 739-7733
Fax
(516) 861-3860
NPI assigned
Jun 8, 2006
Last updated
Sep 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Authorized official

Name
Mr. Lawrence Boord
Title
Cfo
Phone
(516) 739-7733

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 6751100 NY
Voluntary or Charitable Agency 251V00000X 675100 NY Primary

Addresses

Primary practice location

1500 Hempstead Tpke
East Meadow, NY 11554-1551

Mailing address

1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone (516) 739-7733

Other identifiers 1

IdentifierTypeStateIssuer
00355028MedicaidNY

Other names 1

  • Epilepsy Foundation of Long Island Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000757 NY Part B Supplier - Clinic/Group Practice 7315835907 Receives reassigned benefits from 109 practitioners
1 other NPI on this enrollment
Practice locations: Hicksville, NY; Yaphank, NY; Woodbury, NY; Wantagh, NY; Riverhead, NY; Port Jefferson Station, NY; Peekskill, NY; Patchogue, NY…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

Practitioners & affiliated clinicians

Practitioners 117

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 117

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1174563936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541551",
            "telephone_number": "516-739-7733",
            "fax_number": "516-861-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541551",
            "telephone_number": "516-739-7733",
            "fax_number": "516-861-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC LONG ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "BOORD",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-739-7733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NY",
            "license": "6751100",
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NY",
            "license": "675100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355028",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Epilepsy Foundation of Long Island",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.