Individual provider Active NPI

Maliakal Joseph Anto, MD

  • Cardiovascular Disease Physician
  • Syosset, NY
National Provider Identifier
1417026394
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
141007 Issued in NY
Practice address
8 Greenfield Rd
Syosset, NY 11791
Phone
(516) 496-7900
Fax
(516) 496-2139
NPI assigned
Nov 7, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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 141007 NY
Cardiovascular Disease Physician 207RC0000X 141007 NY Primary

Addresses

Primary practice location

8 Greenfield Rd
Syosset, NY 11791

Mailing address

8 Greenfield Rd
Syosset, NY 11791
Phone (516) 496-7900

Other identifiers 1

IdentifierTypeStateIssuer
00649610MedicaidNY

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
I20040603000360 NY Practitioner - Cardiovascular Disease (Cardiology) 7517949571 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141007NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Cardio Pulmonary Associates PC Internal Medicine Current Accepting new patients
North Shore - Lij Medical Group at Syosset PC Cardiovascular Disease CurrentSince Feb 1, 2011 Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

270 Park Ave
Fl 1
Huntington, NY 11743
Phone (631) 351-2219

300 Community Dr
Manhasset, NY 11030

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

221 Jericho Tpke
#1N
Syosset, NY 11791
Phone (516) 496-6582

8 Greenfield Rd
Syosset, NY 11791
Phone (516) 496-3001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1417026394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GREENFIELD RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-496-7900",
            "fax_number": "516-496-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GREENFIELD RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-496-7900",
            "fax_number": "516-496-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTO",
        "first_name": "MALIAKAL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "141007",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "141007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00649610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.