Individual provider Active NPI

Lisa Anne Forgione, M.D.

  • Pediatrics Physician
  • Rockville Centre, NY
National Provider Identifier
1255438222
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202250 Issued in NY
Practice address
165 N Village Ave
Suite 215
Rockville Centre, NY 11570-3761
Phone
(516) 536-7200
Fax
(516) 536-7208
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 202250 NY Primary

Addresses

Primary practice location

165 N Village Ave
Suite 215
Rockville Centre, NY 11570-3761

Mailing address

165 N Village Ave
Suite 215
Rockville Centre, NY 11570-3761
Phone (516) 536-7200

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
I20180706002258 NY Practitioner - Pediatric Medicine 0840546735 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Philadelphia, PA 19195

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1255438222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE",
            "address_2": "SUITE 215",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703761",
            "telephone_number": "516-536-7200",
            "fax_number": "516-536-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE",
            "address_2": "SUITE 215",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703761",
            "telephone_number": "516-536-7200",
            "fax_number": "516-536-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORGIONE",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "202250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.