NPIMap

Organization Active NPI

Lake Success Neurological Surgery PC

Doing business as Intra-Operative Monitoring Associates

  • EEG Specialist/Technologist
  • New Hyde Park, NY
National Provider Identifier
1487984522
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EEG Specialist/TechnologistTaxonomy code 246ZE0500X
Legal business name
LAKE SUCCESS NEUROLOGICAL SURGERY PC
Doing business as
Intra-Operative Monitoring Associates
Practice address
1991 Marcus Ave
Suite 108
New Hyde Park, NY 11042-2057
Phone
(516) 442-2250
Fax
(516) 442-1897
NPI assigned
Jan 13, 2010
Last updated
Jan 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Authorized official

Name
Dr. Michael H Brisman, M.D.NPI 1255355475
Title
Ceo
Phone
(516) 255-9031

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EEG Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246ZE0500X Primary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

1991 Marcus Ave
Suite 108
New Hyde Park, NY 11042-2057

Mailing address

1991 Marcus Ave
Suite 108
New Hyde Park, NY 11042-2057
Phone (516) 442-2250

Other names 1

  • Intra-Operative Monitoring Associates Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1487984522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "SUITE 108",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-442-2250",
            "fax_number": "516-442-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "SUITE 108",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-442-2250",
            "fax_number": "516-442-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SUCCESS NEUROLOGICAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "BRISMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-255-9031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "246ZE0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intra-Operative Monitoring Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.