NPIMap

Organization Active NPI

Long Island Neurology Consultants

  • Neurology Physician
  • Lynbrook, NY
National Provider Identifier
1467438622
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
120379,152638,159236 Issued in NY
Legal business name
LONG ISLAND NEUROLOGY CONSULTANTS
Practice address
360 Merrick Rd FL 1
Lynbrook, NY 11563-2526
Phone
(516) 887-3516
Fax
(516) 887-0331
NPI assigned
Dec 20, 2005
Last updated
Sep 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Mrs. Donna Bocci
Title
Office Manager
Phone
(516) 887-3516

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 120379,152638,159236 NY Primary
Diagnostic Radiology Physician 2085R0202X 147527 NY
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

360 Merrick Rd FL 1
Lynbrook, NY 11563-2526

Mailing address

360 Merrick Rd FL 1
Lynbrook, NY 11563-2526
Phone (516) 887-3516

Other identifiers 1

IdentifierTypeStateIssuer
02597928MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address records@linc.criterionsdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080925000460 NY Part B Supplier - Clinic/Group Practice 8729155239 Receives reassigned benefits from 10 practitioners
Practice locations: Lynbrook, NY

National Provider Directory

National Provider Directory

Locations

360 Merrick Rd
Fl 1
Lynbrook, NY 11563
Phone (516) 887-3516

777 Sunrise Hwy
Ste 200
Lynbrook, NY 11563
Phone (516) 887-3516

Interoperability endpoints

  • Direct secure messaging: records@linc.criterionsdirect.com

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1467438622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRICK RD FL 1",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632526",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRICK RD FL 1",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632526",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND NEUROLOGY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "BOCCI",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-887-3516",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "120379,152638,159236",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "147527",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02597928",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@linc.criterionsdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "360 Merrick Rd Fl 1",
            "city": "Lynbrook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115632526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.