NPIMap

Individual provider Active NPI

Philip Fortunato Spadafora, DO

  • Internal Medicine Physician
  • Garden City, NY
National Provider Identifier
1255386959
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1878871 Issued in NY
Practice address
901 Stewart Ave
Ste 275
Garden City, NY 11530
Phone
(516) 877-1518
Fax
(516) 877-1561
NPI assigned
May 23, 2006
Last updated
May 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1878871 NY Primary

Addresses

Primary practice location

901 Stewart Ave
Ste 275
Garden City, NY 11530

Mailing address

901 Stewart Ave
Ste 275
Garden City, NY 11530
Phone (516) 877-1518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000704 NY Practitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 7214979038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Physical Medicine and Rehabilitation
Education
New York College of Osteo Medicine of New York Institute of Technology, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

901 Stewart Ave
Suite 275
Garden City, NY 11530-4889
Phone (516) 877-1518

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
31.41 of 100Reported as individual
Quality
24.36
Improvement activities
0
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1878871NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Professional Medical Services PC Internal Medicine CurrentSince Jan 1, 2003 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

901 Stewart Ave
Ste 275
Garden City, NY 11530
Phone (516) 877-1518

Interoperability endpoints

  • Direct secure messaging: pspadafora307574@nyumc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1255386959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 STEWART AVE",
            "address_2": "STE 275",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-877-1518",
            "fax_number": "516-877-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 STEWART AVE",
            "address_2": "STE 275",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-877-1518",
            "fax_number": "516-877-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADAFORA",
        "first_name": "PHILIP",
        "middle_name": "FORTUNATO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1878871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.