Individual provider Active NPI

Michael Andrew Tymon, MD

  • Cardiovascular Disease Physician
  • Seaford, NY
National Provider Identifier
1215424148
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
309262 Issued in NY
Practice address
850 Hicksville Rd Ste 104
Seaford, NY 11783-1300
Phone
(516) 798-0141
Fax
(516) 809-4225
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 309262 NY
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 309262 NY Primary

Addresses

Primary practice location

850 Hicksville Rd Ste 104
Seaford, NY 11783-1300

Mailing address

222 Station PLZ N Ste 509
Mineola, NY 11501-3893
Phone (516) 663-2381

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
I20241226001015 NY Practitioner - Cardiovascular Disease (Cardiology) 6103353529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Albert Einstein College of Medicine of Yeshiva University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwell Healthcare IncGroup PAC ID 3971531039, 17 clinicians

Practice addresses (Care Compare)

850 Hicksville Rd
Suite 104
Seaford, NY 11783-1300
Phone (516) 809-4200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309262NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Health Care Inc Multi-Specialty CurrentSince Oct 21, 2024 Accepting new patients
North Shore Long Island Jewish Healthcare Multi-Specialty CurrentSince Oct 21, 2024 Accepting new patients

Locations

27005 76th Ave
North New Hyde Pk, NY 11040

850 Hicksville Rd
Ste 110
Seaford, NY 11783
Phone (516) 735-5454

850 Hicksville Rd
Ste 104
Seaford, NY 11783
Phone (516) 798-0141

Networks

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

Interoperability endpoints

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1215424148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 509",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013893",
            "telephone_number": "516-663-2381",
            "fax_number": "516-663-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HICKSVILLE RD STE 104",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831300",
            "telephone_number": "516-798-0141",
            "fax_number": "516-809-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMON",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "309262",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "309262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, NY

Sources for this page

Verify at the official NPI Registry.