Individual provider Active NPI

John Martin Nelson Jr., MD

  • Orthopaedic Surgery Physician
  • Purchase, NY
National Provider Identifier
1245328103
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
150073 Issued in NY
Practice address
3010 Westchester Ave
Suite 104
Purchase, NY 10577-2535
Phone
(914) 967-8708
Fax
(914) 967-5834
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 150073 NY Primary
Pediatric Orthopaedic Surgery Physician 207XP3100X 150073 NY
Orthopaedic Surgery Physician 207X00000X 28357 CT
Pediatric Orthopaedic Surgery Physician 207XP3100X 28357 CT

Addresses

Primary practice location

3010 Westchester Ave
Suite 104
Purchase, NY 10577-2535

Mailing address

3010 Westchester Ave
Suite 104
Purchase, NY 10577-2535
Phone (914) 967-8708

Other identifiers 1

IdentifierTypeStateIssuer
00970338MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050510001034 CT Practitioner - Orthopedic Surgery 3577503747 Reassigns benefits to 1 organization
I20090410000046 NY Practitioner - Orthopedic Surgery 3577503747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Icahn School of Medicine at Mount Sinai, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

27005 76TH Ave
Suite 222
New Hyde Park, NY 11040-1402
Phone (718) 470-7260

32 Strawberry Hill CT
Stamford, CT 06902-2594
Phone (914) 967-8708

Hospital & facility affiliations

  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261
  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28357CTMDOrthopaedic Surgery Physician
150073NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Orthopaedic Surgery CurrentSince Jun 1, 2021 Accepting new patients

Locations

945 Summer St
Stamford, CT 06905
Phone (203) 276-4309

32 Strawberry Hill Ct
Fl 4
Stamford, CT 06902
Phone (203) 276-4255

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

27005 76th Ave
#222
New Hyde Park, NY 11040
Phone (718) 470-7260

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: jnelson25928@northwell.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1245328103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 WESTCHESTER AVE",
            "address_2": "SUITE 104",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772535",
            "telephone_number": "914-967-8708",
            "fax_number": "914-967-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 WESTCHESTER AVE",
            "address_2": "SUITE 104",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772535",
            "telephone_number": "914-967-8708",
            "fax_number": "914-967-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "150073",
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NY",
            "license": "150073",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "28357",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "CT",
            "license": "28357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00970338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

Verify at the official NPI Registry.