Individual provider Active NPI

Matthew Jonathan Siegel, DDS

  • Dentist
  • Bellmore, NY
National Provider Identifier
1427467802
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50 057441 Issued in NY
Practice address
2592 Merrick Rd
Suite C
Bellmore, NY 11710-5742
Phone
(516) 781-9700
Fax
(516) 781-1936
NPI assigned
Aug 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50 057441 NY Primary

Addresses

Primary practice location

2592 Merrick Rd
Suite C
Bellmore, NY 11710-5742

Mailing address

2592 Merrick Rd
Suite C
Bellmore, NY 11710-5742
Phone (516) 781-9700

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713000806 NY Order and Referring Only - DentistPractitioner - Dentist 0244542728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50 057441NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1427467802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 MERRICK RD",
            "address_2": "SUITE C",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105742",
            "telephone_number": "516-781-9700",
            "fax_number": "516-781-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 MERRICK RD",
            "address_2": "SUITE C",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105742",
            "telephone_number": "516-781-9700",
            "fax_number": "516-781-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "MATTHEW",
        "middle_name": "JONATHAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-11",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "50 057441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

Verify at the official NPI Registry.