NPIMap

Individual provider Active NPI

Roger Perrone, M.D.

  • Internal Medicine Physician
  • Northport, NY
National Provider Identifier
1417905696
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
175975 Issued in NY
Practice address
1019 Fort Salonga Rd
Suite 101
Northport, NY 11768-2270
Phone
(631) 262-1314
Fax
(631) 262-1328
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 175975 NY Primary

Addresses

Primary practice location

1019 Fort Salonga Rd
Suite 101
Northport, NY 11768-2270

Mailing address

1019 Fort Salonga Rd
Suite 101
Northport, NY 11768-2270
Phone (631) 262-1314

Other identifiers 2

IdentifierTypeStateIssuer
01197777MedicaidNY
W34601OtherNYGROUP UPIN

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
I20110719000033 NY Practitioner - Internal Medicine 6103094206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
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)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3058

Hospital & facility affiliations

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
175975NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 19, 2023 Accepting new patients
North Suffolk Medical Associates, P.C. CurrentSince Oct 1, 1999 Accepting new patients

Locations

721 Fort Salonga Rd
Northport, NY 11768
Phone (631) 261-0444

1019 Fort Salonga Rd
Ste 101
Northport, NY 11768
Phone (516) 262-1314

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

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

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1417905696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 FORT SALONGA RD",
            "address_2": "SUITE 101",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682270",
            "telephone_number": "631-262-1314",
            "fax_number": "631-262-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 FORT SALONGA RD",
            "address_2": "SUITE 101",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682270",
            "telephone_number": "631-262-1314",
            "fax_number": "631-262-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRONE",
        "first_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01197777",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP UPIN",
            "identifier": "W34601",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.