Individual provider Active NPI

Ira Klonsky, M.D.

  • Surgery Physician
  • Valley Stream, NY
National Provider Identifier
1174564264
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
137566 Issued in NY
Practice address
210 E Sunrise Hwy
Suite 303
Valley Stream, NY 11581-1329
Phone
(516) 568-9119
Fax
(516) 568-9485
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 137566 NY Primary

Addresses

Primary practice location

210 E Sunrise Hwy
Suite 303
Valley Stream, NY 11581-1329

Mailing address

210 E Sunrise Hwy
Suite 303
Valley Stream, NY 11581-1329
Phone (516) 568-9119

Other identifiers 1

IdentifierTypeStateIssuer
00775159MedicaidNY

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
I20061219000543 NY Practitioner - General SurgeryPractitioner - Other (Physician) 1153320254 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Valley Stream, NY

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

210 E Sunrise Hwy
Suite 303
Valley Stream, NY 11581-1328
Phone (516) 568-9800

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 256-6554

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)12
Melanoma (skin cancer) excision1-10
Removal of tissue46
Removal of skin lesions43
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
137566NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Nov 15, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 15, 2023 Accepting new patients
Brooklyn Surgical Group P.C. Surgery Past Accepting new patients
TJH Medical Services, P.C. Surgery Past Accepting new patients
Ira Klonsky PastSince Jan 1, 1990 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

Networks

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

Interoperability endpoints

  • Direct secure messaging: iraklonsky@nslijmedgr.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 1

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

Organizations & group practices 6

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 3

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1174564264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E SUNRISE HWY",
            "address_2": "SUITE 303",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811329",
            "telephone_number": "516-568-9119",
            "fax_number": "516-568-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E SUNRISE HWY",
            "address_2": "SUITE 303",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811329",
            "telephone_number": "516-568-9119",
            "fax_number": "516-568-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLONSKY",
        "first_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "137566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00775159",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.