Organization Active NPI

Bernard Hoffman M.D. P.C.

  • Adult Mental Health Clinic/Center
  • Dix Hills, NY
National Provider Identifier
1225308778
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
104064 Issued in NY
Legal business name
BERNARD HOFFMAN M.D. P.C.
Practice address
12 Faulkner LN
Dix Hills, NY 11746-5906
Phone
(631) 549-1567
Fax
(631) 549-1567
NPI assigned
Dec 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Dr. Bernard Hoffman, M.D.NPI 1689635815
Title
President
Phone
(631) 549-1567

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 104064 NY Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 104064 NY

Addresses

Primary practice location

12 Faulkner LN
Dix Hills, NY 11746-5906

Mailing address

12 Faulkner LN
Dix Hills, NY 11746-5906
Phone (631) 549-1567

Other identifiers 1

IdentifierTypeStateIssuer
588781OtherNYMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120207000577 NY Part B Supplier - Clinic/Group Practice 9335306067 Receives reassigned benefits from 1 practitioner
Practice locations: Dix Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1325203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1225308778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FAULKNER LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465906",
            "telephone_number": "631-549-1567",
            "fax_number": "631-549-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 FAULKNER LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465906",
            "telephone_number": "631-549-1567",
            "fax_number": "631-549-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD HOFFMAN M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-30",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-549-1567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "104064",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NY",
            "license": "104064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "588781",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.