Individual provider Active NPI

Jeffrey S Nudelman, MD

  • Specialist
  • Babylon, NY
National Provider Identifier
1417936469
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
175528-1 Issued in NY
Practice address
500 W Main St
#210
Babylon, NY 11702-3027
Phone
(631) 957-3355
Fax
(631) 957-4378
NPI assigned
Jan 10, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 175528-1 NY Primary

Addresses

Primary practice location

500 W Main St
#210
Babylon, NY 11702-3027

Mailing address

500 W Main St
Suite 210
Babylon, NY 11702-3027
Phone (631) 957-3355

Other identifiers 1

IdentifierTypeStateIssuer
01129991MedicaidNY

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
I20100126000417 NY Practitioner - Ophthalmology 8820190036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Cincinnati College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight Medical Doctors PLLCGroup PAC ID 5991935173, 115 clinicians

Practice addresses (Care Compare)

500 W Main St
Suite 210
Babylon, NY 11702-3028
Phone (631) 265-8780

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175528-1NYMDSpecialist
1755281NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Medical Doctors PLLC CurrentSince Sep 1, 2018 Accepting new patients
Sight Medical Doctors PLLC CurrentSince Sep 1, 2018 Accepting new patients

Locations

333 Broadway
Ste 1
Amityville, NY 11701
Phone (631) 608-1542

805 Broadway
Ste 106
Amityville, NY 11701
Phone (631) 957-3355

500 W Main St
Ste 210
Babylon, NY 11702
Phone (631) 957-3355

125 Kennedy Dr
Ste 400
Hauppauge, NY 11788

260 E Middle Country Rd
Ste 109
Smithtown, NY 11787
Phone (631) 361-3577

260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150

786 Montauk Hwy
West Islip, NY 11795
Phone (631) 376-6075

Networks

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

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, 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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1417936469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE 210",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023027",
            "telephone_number": "631-957-3355",
            "fax_number": "631-957-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "#210",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023027",
            "telephone_number": "631-957-3355",
            "fax_number": "631-957-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUDELMAN",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "175528-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01129991",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

Verify at the official NPI Registry.