Organization Active NPI

Neil L. Bellet M.D. and Lawrence M. Wells M.D.,LLP

  • Dermatology Physician
  • Medford, NY
National Provider Identifier
1194864314
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NEIL L. BELLET M.D. AND LAWRENCE M. WELLS M.D.,LLP
Practice address
1735 N Ocean Ave
Suite C
Medford, NY 11763-2649
Phone
(631) 475-5550
Fax
(631) 475-5584
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Authorized official

Name
Dr. Neil L Bellet, MDNPI 1457368292
Title
MD
Phone
(631) 475-5550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1735 N Ocean Ave
Suite C
Medford, NY 11763-2649

Mailing address

1735 N Ocean Ave
Suite C
Medford, NY 11763-2649
Phone (631) 475-5550

Other identifiers 3

IdentifierTypeStateIssuer
106532OtherHIP
0807740OtherNYAETNA
2299975OtherNYGHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080807000096 NY Part B Supplier - Clinic/Group Practice 6507930633 Receives reassigned benefits from 2 practitioners
Practice locations: Medford, NY

National Provider Directory

National Provider Directory

Locations

1735 N Ocean Ave
Ste C
Medford, NY 11763
Phone (516) 475-5550

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1194864314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 N OCEAN AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-475-5550",
            "fax_number": "631-475-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 N OCEAN AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-475-5550",
            "fax_number": "631-475-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL L. BELLET M.D. AND LAWRENCE M. WELLS M.D.,LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "BELLET",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "631-475-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "106532",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0807740",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2299975",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.