NPIMap

Organization Active NPI

Long Island Minimally Invasive Surgery, P.C.

  • Specialist
  • Roslyn Heights, NY
National Provider Identifier
1356545867
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
199144 Issued in NY
Legal business name
LONG ISLAND MINIMALLY INVASIVE SURGERY, P.C.
Practice address
125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2023
Phone
(516) 616-5500
Fax
(888) 502-6582
NPI assigned
Jun 11, 2007
Last updated
Feb 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Authorized official

Name
Dr. Shawn Garber, MDNPI 1093743320
Title
President
Phone
(516) 616-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 199144 NY Primary

Addresses

Primary practice location

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2023

Mailing address

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2023
Phone (516) 616-5500

Other names 1

  • New York Bariatric Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111007000574 NY Part B Supplier - Clinic/Group Practice 1658541347 Receives reassigned benefits from 54 practitioners
Practice locations: West Nyack, NY; West Islip, NY; Staten Island, NY; Roslyn Heights, NY; Riverhead, NY; Port Jefferson, NY; Patchogue, NY; Merrick, NY…
O20180410000019 CT Part B Supplier - Clinic/Group Practice 1658541347 Receives reassigned benefits from 10 practitioners
Practice locations: Fairfield, CT; Farmington, CT; Stamford, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1098065Long Island Minimally Invasive Surgery PC125 Mineola Avenue, # 200, Roslyn Heights, NY 11577Certificate of waiverApr 9, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

345 Colt Hwy
Farmington, CT 06032
Phone 5166165500 ext. 107

345 Colt Hwy
Ste C
Farmington, CT 06032

120 E Main St
Huntington, NY 11743
Phone (631) 300-2484

560 Sunrise Hwy
West Islip, NY 11795

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1356545867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MINEOLA AVE",
            "address_2": "SUITE 200",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772023",
            "telephone_number": "516-616-5500",
            "fax_number": "888-502-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MINEOLA AVE",
            "address_2": "SUITE 200",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772023",
            "telephone_number": "516-616-5500",
            "fax_number": "888-502-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND MINIMALLY INVASIVE SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "GARBER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-616-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "199144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Bariatric Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.