Individual provider Active NPI

Elliot Jay Nadelson, MD

  • Urology Physician
  • New York, NY
National Provider Identifier
1417965146
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
140064 Issued in NY
Practice address
53 W 36TH St Ste 204a
New York, NY 10018-7903
Phone
(212) 727-2887
Fax
(646) 774-0936
NPI assigned
Aug 5, 2006
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 140064 NY Primary
General Practice Physician 208D00000X 140064 NY
General Practice Physician 208D00000X C145147 CA

Addresses

Primary practice location

53 W 36TH St Ste 204a
New York, NY 10018-7903

Mailing address

53 W 36TH St Ste 204a
New York, NY 10018-7903
Phone (212) 727-2887

Other identifiers 1

IdentifierTypeStateIssuer
00776747MedicaidNY

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
I20111123000172 NY Practitioner - UrologyPractitioner - General Practice 4486828779 Reassigns benefits to 2 organizations
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: General Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C145147CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dimitri N Kessaris MDPC Urology CurrentSince May 1, 2021 Accepting new patients
Alfred Shtainer MD PC Urology PastSince Mar 22, 2017 Accepting new patients

Locations

315 E Shore Rd
Manhasset, NY 11030
Phone (516) 773-6611

Networks

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

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1417965146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W 36TH ST STE 204A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187903",
            "telephone_number": "212-727-2887",
            "fax_number": "646-774-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W 36TH ST STE 204A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187903",
            "telephone_number": "212-727-2887",
            "fax_number": "646-774-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADELSON",
        "first_name": "ELLIOT",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "140064",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "140064",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "C145147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00776747",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.