Individual provider Active NPI

Jeffrey E Mallin, MD

  • Neurology Physician
  • New Hyde Park, NY
National Provider Identifier
1417920604
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
156720 Issued in NY
Practice address
3003 New Hyde Park Rd
Suite 200
New Hyde Park, NY 11042-1214
Phone
(516) 488-1888
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 156720 NY
Neurology Physician 2084N0400X 156720 NY Primary

Addresses

Primary practice location

3003 New Hyde Park Rd
Suite 200
New Hyde Park, NY 11042-1214

Mailing address

3003 New Hyde Park Rd
200
New Hyde Park, NY 11042-1214
Phone (516) 488-1888

Other identifiers 1

IdentifierTypeStateIssuer
01835047MedicaidNY

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
I20041204000224 NY Practitioner - Neurology 9234193186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Neurologic Associates LLPGroup PAC ID 5991769846, 7 clinicians

Practice addresses (Care Compare)

3003 New Hyde Park Rd
Suite 200
New Hyde Park, NY 11042-1214
Phone (516) 488-1888

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
67.97 of 100Reported as group
Quality
28.7
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156720NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Neurologic Associates, LLP Specialist CurrentSince Jan 1, 1987 Accepting new patients

Locations

3003 New Hyde Park Rd
Ste 200
New Hyde Park, NY 11042
Phone (516) 488-1888

Networks

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

Organizations & group practices 1

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1417920604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD",
            "address_2": "200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421214",
            "telephone_number": "516-488-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD",
            "address_2": "SUITE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421214",
            "telephone_number": "516-488-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIN",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "156720",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "156720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01835047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.