Individual provider Active NPI

Roopal Sampat, M.D.

  • Nephrology Physician
  • Bellmore, NY
National Provider Identifier
1457511982
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
262666 Issued in NY
Practice address
250 Pettit Avenue
Bellmore, NY 11710-3657
Phone
(516) 783-4105
Fax
(516) 783-4352
NPI assigned
Jun 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 262666 NY Primary

Addresses

Primary practice location

250 Pettit Avenue
Bellmore, NY 11710-3657

Mailing address

PO Box 416173
Boston, MA 02241-6173
Phone (610) 644-8900

Other identifiers 2

IdentifierTypeStateIssuer
03487721MedicaidNY
735M81OtherNYBLUE CROSS

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
I20120626000358 NY Practitioner - NephrologyPractitioner - Internal Medicine 1153586102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 Community Dr
Great Neck, NY 11021-5501
Phone (516) 465-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.1 of 100Reported as group
Quality
82.06
Improvement activities
40
Cost
74.25

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.95 of 100Reported as group
Quality
76.17
Promoting interoperability
99
Improvement activities
40
Cost
67.84

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Kidney and Hypertension PC Nephrology CurrentSince Jul 1, 2016 Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 30, 2024 Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 30, 2024 Accepting new patients
Prine Health Medical Group, PLLC Nephrology PastSince Apr 15, 2015 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

17660 Union Tpke
Fresh Meadows, NY 11366
Phone (212) 774-2474

891 Northern Blvd
Ste 203
Great Neck, NY 11021
Phone (516) 773-6300

100 Community Dr
Great Neck, NY 11021
Phone (516) 365-1805

600 Northern Blvd
Ste 115
Great Neck, NY 11021
Phone (516) 466-6760

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

Networks

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

Organizations & group practices 4

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 1

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1457511982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416173",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416173",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVENUE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103657",
            "telephone_number": "516-783-4105",
            "fax_number": "516-783-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPAT",
        "first_name": "ROOPAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "262666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03487721",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "735M81",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

Verify at the official NPI Registry.