Individual provider Active NPI

Robert Anthony Dimino, PHD

  • Clinical Neurophysiology Physician
  • Great Neck, NY
National Provider Identifier
1306803036
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
016046 Issued in NY
Practice address
175 Community Dr
Great Neck, NY 11021-5502
Phone
(516) 465-1900
Fax
(516) 465-1830
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PC 6,374 clinicians

Practice addresses (Care Compare)

1983 Marcus Ave
New Hyde Park, NY 11042-2000
Phone (718) 470-3440

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Merit-based Incentive Payment System (MIPS)

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

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050730000094 NY Practitioner - Clinical Psychologist 2860420981 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034052NYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients

Locations

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

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

1983 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 326-5600

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: robertdimino@nslijmedgr.allscriptsdirect.net

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 016046 NY Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 034052 NY

Addresses

NPPES NPI Registry

Primary practice location

175 Community Dr
Great Neck, NY 11021-5502

Mailing address

1983 Marcus Ave
Long Island Jewish Medical Ctr
Lake Success, NY 11042-1016
Phone (516) 802-6121

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2010.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1306803036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 MARCUS AVE",
            "address_2": "LONG ISLAND JEWISH MEDICAL CTR",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421016",
            "telephone_number": "516-802-6121",
            "fax_number": "516-616-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 COMMUNITY DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215502",
            "telephone_number": "516-465-1900",
            "fax_number": "516-465-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMINO",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "016046",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "034052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.