NPIMap

Organization Active NPI

Long Island Spine Rehabilitation Medicine, PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • East Meadow, NY
National Provider Identifier
1215026471
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
LONG ISLAND SPINE REHABILITATION MEDICINE, PC
Practice address
801 Merrick Ave
East Meadow, NY 11554-4748
Phone
(516) 393-8941
Fax
(516) 393-8870
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jason S Lipetz, M.DNPI 1881783116
Title
President
Phone
(516) 393-8941

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
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X Primary

Addresses

Primary practice location

801 Merrick Ave
East Meadow, NY 11554-4748

Mailing address

801 Merrick Ave
East Meadow, NY 11554-4748
Phone (516) 393-8941

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061214000393 NY Part B Supplier - Clinic/Group Practice 2668471962 Receives reassigned benefits from 7 practitioners
Practice locations: East Meadow, NY; Great Neck, NY; Huntington, NY; Lawrence, NY

National Provider Directory

National Provider Directory

Locations

1160 E Jericho Tpke
Huntington, NY 11743
Phone 6316763749571

1160 E Jericho Tpke
Ste 123
Huntington, NY 11743
Phone (631) 547-3400

625 Rockaway Tpke
Lawrence, NY 11559
Phone (516) 336-5227

150 Sunrise Hwy
Ste L20
Lindenhurst, NY 11757
Phone (631) 439-5202

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215026471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MERRICK AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544748",
            "telephone_number": "516-393-8941",
            "fax_number": "516-393-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MERRICK AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544748",
            "telephone_number": "516-393-8941",
            "fax_number": "516-393-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND SPINE REHABILITATION MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIPETZ",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-393-8941",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.