Individual provider Active NPI

Fred A Lado, MD

  • Clinical Neurophysiology Physician
  • Great Neck, NY
National Provider Identifier
1346325644
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
196511 Issued in NY
Practice address
611 Northern Blvd Ste 150
Great Neck, NY 11021-5207
Phone
(516) 325-7000
Fax
(516) 325-7001
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 196511 NY
Clinical Neurophysiology Physician 2084N0600X 196511 NY Primary

Addresses

Primary practice location

611 Northern Blvd Ste 150
Great Neck, NY 11021-5207

Mailing address

215 W 92ND St
Apt 7J
New York, NY 10025-7444
Phone (917) 608-1881

Other identifiers 12

IdentifierTypeStateIssuer
2530734OtherNYUS HEALTH - AETNA PIN
P2852741OtherNYOXFORD PIN
13-1740114OtherNYMMC TAX ID
30200OtherNYMONTE CMO
439N91OtherNYBLUE SHIELD PIN
N65876OtherNYHEALTHNET-PHS PIN
0099245OtherNYCIGNA PIN
196511OtherNYNYS LICENSE
P2456425OtherNYOXFORD PIN
02276882MedicaidNY
10000021415OtherNYAFFINITY HEALTH PIN
196511-A14OtherNYHEALTH FIRST PIN

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
I20080118000106 NY Practitioner - Neurology 2860573672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (631) 675-4550

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

17660 Union Tpke
Fresh Meadows, NY 11366-1526
Phone (718) 820-9015

270 E Main St
Bay Shore, NY 11706-8420
Phone (631) 591-7474

270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2356

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

300 Community Dr
Manhasset, NY 11030-3816

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

301 E Main St
Bay Shore, NY 11706-8408

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

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

370 E Main St
Suite 1
Bay Shore, NY 11706-8415
Phone (631) 666-4767

611 Northern Blvd
Great Neck, NY 11021-5207
Phone (718) 683-3766

611 Northern Blvd
Suite 200
Great Neck, NY 11021-5201
Phone (516) 723-2663

611 Northern Boulevard
Suite 250
Great Neck, NY 11021-5207
Phone (516) 233-3456

865 Northern Boulevard
Suite 302
Great Neck, NY 11021-5207
Phone (516) 570-4400

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 719-3000

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 719-5024

Hospital & facility affiliations

  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
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

LicenseStateTypeSpecialty
196511NYMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 27, 2017 Accepting new patients
North Shore University Hospital Past Accepting new patients
Montefiore North Ambulatory Care Center Inc Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

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

611 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 325-7000

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: flado67013@northwell.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346325644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W 92ND ST",
            "address_2": "APT 7J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257444",
            "telephone_number": "917-608-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 NORTHERN BLVD STE 150",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215207",
            "telephone_number": "516-325-7000",
            "fax_number": "516-325-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADO",
        "first_name": "FRED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "196511",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "196511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTH - AETNA PIN",
            "identifier": "2530734",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PIN",
            "identifier": "P2852741",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMC TAX ID",
            "identifier": "13-1740114",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTE CMO",
            "identifier": "30200",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "439N91",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET-PHS PIN",
            "identifier": "N65876",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "0099245",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "196511",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PIN",
            "identifier": "P2456425",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02276882",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFINITY HEALTH PIN",
            "identifier": "10000021415",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST PIN",
            "identifier": "196511-A14",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.