Individual provider Active NPI

Stephanie Soberanis Pikul, NP

  • Family Nurse Practitioner
  • Great Neck, NY
National Provider Identifier
1396452462
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350595 Issued in NY
Practice address
560 Northern Blvd
Great Neck, NY 11021-5118
Phone
(516) 487-6200
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350595 NY Primary

Addresses

Primary practice location

560 Northern Blvd
Great Neck, NY 11021-5118

Mailing address

115 7TH Ave
Holtsville, NY 11742-2386
Phone (347) 218-0116

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230517001271 NY Practitioner - Nurse Practitioner 7618333691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Pain Consultants LLCGroup PAC ID 0749260107, 19 clinicians

Practice addresses (Care Compare)

500 W Main St
Suite 116
Babylon, NY 11702-3032
Phone (631) 422-6166

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.52 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York Pain Consultants LLC CurrentSince Feb 8, 2023 Accepting new patients
New York Pain Consultants LLC CurrentSince Feb 8, 2023 Accepting new patients
New York Pain Consultants, LLC Past Accepting new patients

Locations

100 W Main St
Ste C
Babylon, NY 11702
Phone (631) 206-1034

500 W Main St
Ste 116
Babylon, NY 11702

8 Saxon Ave
Ste E
Bay Shore, NY 11706
Phone (631) 206-1034

8 Saxon Ave
Bay Shore, NY 11706
Phone (631) 206-2989

Networks

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

Organizations & group practices 3

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": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1396452462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 7TH AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422386",
            "telephone_number": "347-218-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 NORTHERN BLVD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215118",
            "telephone_number": "516-487-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKUL",
        "first_name": "STEPHANIE",
        "middle_name": "SOBERANIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.