Individual provider Active NPI

Lesly Gracia Michel, MD

  • Pediatric Endocrinology Physician
  • Far Rockaway, NY
National Provider Identifier
1194983429
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
251187 Issued in NY
Practice address
495 Beach 20TH St
Far Rockaway, NY 11691-3621
Phone
(347) 619-5950
NPI assigned
May 22, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 251187 NY
Pediatric Endocrinology Physician 2080P0205X 251187 NY Primary

Addresses

Primary practice location

495 Beach 20TH St
Far Rockaway, NY 11691-3621

Mailing address

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (347) 619-5950

Other identifiers 2

IdentifierTypeStateIssuer
03404868MedicaidNY
251187OtherNYLICENSE

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
I20130307000443 NY Practitioner - Pediatric Medicine 6608021100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St John's Medical Services PCGroup PAC ID 1850314865, 89 clinicians

Practice addresses (Care Compare)

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (718) 869-7919

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251187NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St John's Medical Services PC CurrentSince Aug 30, 2017 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients
Episcopal Health Services Inc Past Accepting new patients
South Nassau Communities Hospital Past Accepting new patients

Locations

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

495 Beach 20th St
Far Rockaway, NY 11691
Phone (347) 619-5950

275 Rockaway Tpke
Lawrence, NY 11559
Phone (516) 371-2225

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lesly.michel.1@14448.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194983429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "347-619-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913621",
            "telephone_number": "347-619-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "LESLY",
        "middle_name": "GRACIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "251187",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "251187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03404868",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "251187",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.