Individual provider Active NPI

Demetrios Halikiopoulos, D.O.

  • Ophthalmology Physician
  • Great Neck, NY
National Provider Identifier
1467453506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
217146 Issued in NY
Practice address
107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309
Phone
(516) 466-4670
Fax
(516) 466-4675
NPI assigned
Aug 10, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 217146 NY Primary

Addresses

Primary practice location

107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309

Mailing address

107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309
Phone (516) 466-4670

Other identifiers 1

IdentifierTypeStateIssuer
02176401MedicaidNY

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
I20050406000174 NY Practitioner - Ophthalmology 9234186826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Philadelphia College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309
Phone (516) 466-4670

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Halikiopoulos Ophthalmology, PC Ophthalmology CurrentSince Aug 25, 2004 Accepting new patients
CMC Radiological Services PC Past Accepting new patients

Locations

107 Northern Blvd
Ste 205
Great Neck, NY 11021
Phone (516) 466-4670

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467453506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NORTHERN BLVD",
            "address_2": "SUITE 205",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214309",
            "telephone_number": "516-466-4670",
            "fax_number": "516-466-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NORTHERN BLVD",
            "address_2": "SUITE 205",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214309",
            "telephone_number": "516-466-4670",
            "fax_number": "516-466-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALIKIOPOULOS",
        "first_name": "DEMETRIOS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "217146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02176401",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.