Individual provider Active NPI

Cecilia Elena Gimenez, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Glen Oaks, NY
National Provider Identifier
1366701211
Registry record updated May 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
262680-1 Issued in NY
Practice address
25413 73Rd Rd Apt B
Glen Oaks, NY 11004-1157
Phone
(914) 265-7439
NPI assigned
May 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 262680-1 NY Primary

Addresses

Primary practice location

25413 73Rd Rd Apt B
Glen Oaks, NY 11004-1157

Mailing address

25413 73Rd Rd Apt B
Glen Oaks, NY 11004-1157
Phone (914) 265-7439

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
I20121228000205 NY Practitioner - Pathology 6608029590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6000

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

1111 Marcus Ave
New Hyde Park, NY 11042-1034

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 496-2752

221 Jericho Turnpike
Syosset, NY 11791-4515
Phone (516) 496-6500

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

450 Lakeville Rd
New Hyde Park, NY 11042-1118
Phone (516) 470-8445

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 269-1914

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

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • Plainview Hospital Hospital, Plainview, NY, CCN 330331
  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107

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
262680-1NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Aug 15, 2012 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 15, 2012 Accepting new patients

Locations

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

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

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 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": "1336867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336867200000",
    "number": "1366701211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25413 73RD RD APT B",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041157",
            "telephone_number": "914-265-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25413 73RD RD APT B",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041157",
            "telephone_number": "914-265-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIMENEZ",
        "first_name": "CECILIA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-13",
        "last_updated": "2012-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "262680-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

Verify at the official NPI Registry.