Individual provider Active NPI

Nana Datan, M.D

  • Internal Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1457791394
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
285751-1 Issued in NY
Practice address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone
(516) 674-7300
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 285751-1 NY Primary

Addresses

Primary practice location

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Mailing address

10240 67TH Rd
Apt 3U
Forest Hills, NY 11375-2663
Phone (917) 655-6200

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
I20170710000425 NY Practitioner - Internal MedicinePractitioner - Hospitalist 3577832468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2013
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)

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

Hospital & facility affiliations

  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162
  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285751-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Mar 6, 2025 Accepting new patients
Optum Medical Care, P.C. CurrentSince Oct 1, 2019 Accepting new patients
Optum Medical Care, P.C. CurrentSince Oct 1, 2019 Accepting new patients
Northern Westchester Hospital Association Past Accepting new patients

Locations

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

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

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

300 Community Dr
Plandome, NY 11030

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

972 Brush Hollow Rd
Westbury, NY 11590

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: ndatan66098@northwell.direct-ci.com

Organizations & group practices 5

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 3

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1457791394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 67TH RD",
            "address_2": "APT 3U",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752663",
            "telephone_number": "917-655-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATAN",
        "first_name": "NANA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "285751-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.