Active NPI
Jerrin Varghese
- Neuroradiology Physician
- New York, NY
National Provider Identifier
1255750303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- 297455
- Practice address
- 660 1St Ave
New York, NY 10016-3295 - Phone
- (212) 263-6246
- NPI assigned
- Apr 15, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neuroradiology Physician | 2085N0700X | 297455 | NY | Primary |
Addresses
Primary practice location
660 1St Ave
New York, NY 10016-3295
Mailing address
660 1St Ave
New York, NY 10016-3295
Other practice location 1
Department Of Medicine
HSC Level 16, SUNY Stony Brook
Stony Brook, NY 11794-0001
Phone (631) 444-7411
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- State University of New York Downstate Medical Center, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000
1220 Hicksville Rd
Seaford, NY 11783-1604
Phone (516) 266-3456
Hospital & facility affiliations
- North Shore University Hospital
- Plainview Hospital
- John T Mather Memorial Hospital of Port Jefferson
- Long Island Jewish Medical Center
- NS/Lij HS Southside Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 297455 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Southside Faculty Medical Affiliates University Faculty Practice Corp | Current | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Plandome, NY 11030
9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522
1220 Hicksville Rd
Seaford, NY 11783
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
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 and National Provider Directory roles.
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Body Imaging Physician
- Seaford, NY
- NPI 1033791058
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1093718728
-
- General Acute Care Hospital
- New Hyde Park, NY
- NPI 1285641514
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
-
- General Acute Care Hospital
- Plainview, NY
- NPI 1083621130
-
- General Acute Care Hospital
- Bay Shore, NY
- NPI 1457369381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580688000000",
"number": "1255750303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100163295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100163295",
"telephone_number": "212-263-6246"
}
],
"practiceLocations": [
{
"address_1": "Department Of Medicine",
"address_2": "HSC Level 16, SUNY Stony Brook",
"address_purpose": "LOCATION",
"city": "Stony Brook",
"state": "NY",
"postal_code": "117940001",
"country_code": "US",
"telephone_number": "631-444-7411",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VARGHESE",
"first_name": "JERRIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-15",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "NY",
"license": "297455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.