Individual provider Active NPI

Saumil Hardev Trivedi, MD

  • Pediatrics Physician
  • West Islip, NY
National Provider Identifier
1427372952
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
003482 Issued in NY
Practice address
239 Higbie LN
West Islip, NY 11795-2825
Phone
(631) 376-6000
Fax
(631) 376-6031
NPI assigned
Mar 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 003482 NY Primary

Addresses

Primary practice location

239 Higbie LN
West Islip, NY 11795-2825

Mailing address

889 1St Ave
Franklin Square, NY 11010-1917
Phone (718) 594-3840

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
I20210205000658 NY Practitioner - Pediatric Medicine 0941614754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003482NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

Philadelphia, PA 19195

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.

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1427372952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 1ST AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101917",
            "telephone_number": "718-594-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 HIGBIE LN",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952825",
            "telephone_number": "631-376-6000",
            "fax_number": "631-376-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "SAUMIL",
        "middle_name": "HARDEV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-26",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "003482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.