NPIMap

Individual provider Active NPI

Kenneth Lee Angelino, M.D.

  • Hematology & Oncology Physician
  • Rockville Centre, NY
National Provider Identifier
1376802405
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
293255 Issued in NY
Practice address
242 Merrick Rd Ste 301
South Nassau Oncology Practice, PC
Rockville Centre, NY 11570
Phone
(516) 536-1455
Fax
(516) 536-1598
NPI assigned
May 9, 2012
Last updated
Aug 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 293255 NY Primary

Addresses

Primary practice location

242 Merrick Rd Ste 301
South Nassau Oncology Practice, PC
Rockville Centre, NY 11570

Mailing address

242 Merrick Rd Ste 301
South Nassau Oncology Practice, PC
Rockville Centre, NY 11570-5254
Phone (516) 536-1455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181121002257 NY Practitioner - Hematology/OncologyPractitioner - Internal Medicine 2163654302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-5559

2510 30TH Ave
Long Island City, NY 11102-2448
Phone (718) 932-1000

5 E 98TH St
Suite 6
New York, NY 10029-6501
Phone (212) 241-4812

5 E 98TH St 12TH Floor
Tisch Department of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-8303

8201 37TH Ave
Jackson Heights, NY 11372-7011
Phone (718) 899-0865

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Aug 1, 2024 Accepting new patients
Mount Sinai School of Medicine Current Accepting new patients
Mount Sinai School of Medicine CurrentSince May 1, 2019 Accepting new patients
Mount Sinai School of Medicine Hematology & Oncology CurrentSince May 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Hematology & Oncology CurrentSince May 27, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 27, 2024 Accepting new patients
South Nassau Communities Hospital Current Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Hematology & Oncology CurrentSince Aug 1, 2024 Accepting new patients

Locations

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

8201 37th Ave
Jackson Hts, NY 11372
Phone (718) 335-5800

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

242 Merrick Rd
Ste 301
Rockville Ctr, NY 11570
Phone (516) 536-1455

Networks

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

Interoperability endpoints

  • Direct secure messaging: kennethangelino@snch.allscriptsdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1376802405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MERRICK RD STE 301",
            "address_2": "SOUTH NASSAU ONCOLOGY PRACTICE, PC",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705254",
            "telephone_number": "516-536-1455",
            "fax_number": "516-536-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MERRICK RD STE 301",
            "address_2": "SOUTH NASSAU ONCOLOGY PRACTICE, PC",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-536-1455",
            "fax_number": "516-536-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELINO",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "293255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.