NPIMap

Individual provider Active NPI

Bruce Roy Mayerson, MD

  • Neurology Physician
  • Smithtown, NY
National Provider Identifier
1477657666
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
210222 Issued in NY
Practice address
45 Terry Road
Suite a
Smithtown, NY 11787
Phone
(631) 265-4485
Fax
(631) 265-3620
NPI assigned
Sep 11, 2006
Last updated
May 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 210222 NY Primary

Addresses

Primary practice location

45 Terry Road
Suite a
Smithtown, NY 11787

Mailing address

45 Terry Road
Suite a
Smithtown, NY 11787
Phone (631) 265-4485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000893 NY Practitioner - Neurology 8325028863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of New York Downstate Medical Center, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599

45 Terry Rd
Suite a
Smithtown, NY 11787-3894
Phone (631) 265-4485

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Feb 1, 2016 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Neurology CurrentSince Apr 15, 2013 Accepting new patients
Richard a Pearl MD PC Neurology PastSince Nov 29, 2006 Accepting new patients

Locations

146A Manetto Hill Rd
Plainview, NY 11803
Phone (516) 931-5353

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

45 Terry Rd
Ste A
Smithtown, NY 11787
Phone (631) 265-4485

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: bmayerson13079@direct-chsli.net

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

Hospital & facility affiliations 10

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1477657666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TERRY ROAD",
            "address_2": "SUITE A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-265-4485",
            "fax_number": "631-265-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 TERRY ROAD",
            "address_2": "SUITE A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-265-4485",
            "fax_number": "631-265-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERSON",
        "first_name": "BRUCE",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "210222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.