Frederic A Mendelsohn, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

112676 Issued in NY

Practice address

650 Hawkins Ave
Suite 7
Ronkonkoma, NY 11779-2366

Phone

(631) 737-0055

Fax

(631) 737-0076

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Frederic a Mendelsohn Neurodiagnostics Inc

  • Neuroradiology Physician
  • Port Jefferson, NY
  • NPI 1568926822
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1336247691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117760491",
            "telephone_number": "631-737-0055",
            "fax_number": "631-737-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HAWKINS AVE",
            "address_2": "SUITE 7",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117792366",
            "telephone_number": "631-737-0055",
            "fax_number": "631-737-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELSOHN",
        "first_name": "FREDERIC",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "112676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00655156",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Meadows
• Med Star Surgical & Breathing Equipment, Inc.
• Medical Services of America, PC
• Kaitlynn Rose Meisenheimer
• Robert J Melillo, DC
• Laura A Mendez, LPN
• Sneha Menon
• Mayra C. Mera, LMSW
• Carmen Delia Mercado
• Jodi Michele Merlino, LCSW

• Neurology Physician in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.