Active NPI
Neil Mark Bellovin IV, M.D.
- Pediatrics Physician
- Commack, NY
National Provider Identifier
1194743344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 147752
- Practice address
- 646 Commack Rd
Commack, NY 11725-5404 - Phone
- (631) 499-4114
- Fax
- (631) 499-1468
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 147752 | NY | Primary |
Addresses
Primary practice location
646 Commack Rd
Commack, NY 11725-5404
Mailing address
646 Commack Rd
Commack, NY 11725-5404
Phone (631) 499-4114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01452139 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147752 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RBK Pediatrics PC | Pediatrics | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Commack, NY
- NPI 1417983024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194743344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "646 COMMACK RD",
"city": "COMMACK",
"state": "NY",
"postal_code": "117255404",
"telephone_number": "631-499-4114",
"fax_number": "631-499-1468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "646 COMMACK RD",
"city": "COMMACK",
"state": "NY",
"postal_code": "117255404",
"telephone_number": "631-499-4114",
"fax_number": "631-499-1468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLOVIN",
"first_name": "NEIL",
"middle_name": "MARK",
"name_suffix": "IV",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "147752",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01452139",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Commack, NY
- Behavioral Health Nurse Practitioner Psychiatric Services PC
- Samantha Anne Beil, PA
- Carolina Bejarano Vargas, SA-C
- Doreen Marie Bellantoni, MA CCC-SLP
- Lewis Daobri Belleh, M.S., PT
- Ann M Benjes, CPHT
- Ralph Robert Berardi, DDS
- Jerome D Berg, BS REG PH
- Rachel Bergenstock, LMHC-LP
- Andrew Leigh Berger, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.