Individual provider Active NPI

Edward Skwiersky, MD

  • Cardiovascular Disease Physician
  • Glen Cove, NY
National Provider Identifier
1366436305
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
155082 Issued in NY
Practice address
70 Glen St
Suite 200
Glen Cove, NY 11542-2854
Phone
(516) 484-7893
Fax
(516) 484-5054
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 155082 NY Primary

Addresses

Primary practice location

70 Glen St
Suite 200
Glen Cove, NY 11542-2854

Mailing address

70 Glen Street
Suite 200
Glen Cove, NY 11542-2854
Phone (516) 484-7893

Other identifiers 1

IdentifierTypeStateIssuer
1050760MedicaidNY

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
I20040904000065 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0749256352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Albany Medical College of Union University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Medical Group at North Nassau, PCGroup PAC ID 7618154550, 36 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (516) 674-7460

70 Glen St
Suite 200
Glen Cove, NY 11542-2854
Phone (516) 484-7893

Hospital & facility affiliations

  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij Medical Group at North Nassau, PC Cardiovascular Disease CurrentSince Jun 13, 2011 Accepting new patients

Locations

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

70 Glen St
Ste 200
Glen Cove, NY 11542
Phone (516) 484-7893

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

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

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.

Hospital & facility affiliations 2

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1366436305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLEN STREET",
            "address_2": "SUITE 200",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422854",
            "telephone_number": "516-484-7893",
            "fax_number": "516-484-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST",
            "address_2": "SUITE 200",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422854",
            "telephone_number": "516-484-7893",
            "fax_number": "516-484-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKWIERSKY",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "155082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1050760",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.