Individual provider Active NPI

Michael B Israel, MD

  • Hospitalist Physician
  • Southampton, NY
National Provider Identifier
1366407009
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
147543 Issued in NY
Practice address
240 Meeting House LN
Southampton, NY 11968-5009
Phone
(631) 726-8200
Fax
(631) 726-8886
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1475431 NY
Hospitalist Physician 208M00000X 147543 NY Primary

Addresses

Primary practice location

240 Meeting House LN
Southampton, NY 11968-5009

Mailing address

240 Meeting House LN
Southampton, NY 11968-5009
Phone (631) 726-8200

Other identifiers 1

IdentifierTypeStateIssuer
00662886MedicaidNY

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
I20050420000960 NY Practitioner - Internal Medicine 0840238861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

240 Meeting House LN
Southampton, NY 11968-5009
Phone (631) 726-8400

325 Meeting House LN
Southampton, NY 11968-7000

3330 Noyac Rd
Sag Harbor, NY 11963-1930
Phone (631) 725-2112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1475431NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC Internal Medicine CurrentSince May 15, 2008 Accepting new patients
South Fork Medical Associates PC Internal Medicine PastSince Sep 1, 2005 Accepting new patients

Locations

200 Pantigo Pl
Ste J
East Hampton, NY 11937
Phone (631) 324-7700

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

Networks

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

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.

Hospital & facility affiliations 6

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1366407009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685009",
            "telephone_number": "631-726-8200",
            "fax_number": "631-726-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685009",
            "telephone_number": "631-726-8200",
            "fax_number": "631-726-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1475431",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "147543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00662886",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.