Individual provider Active NPI

Alexander Telis, MD

  • Internal Medicine Physician
  • Great Neck, NY
National Provider Identifier
1508022088
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
244197 Issued in NY
Practice address
46 Schenck Ave
Apt. 2E
Great Neck, NY 11021-3642
Phone
(347) 782-1448
NPI assigned
Aug 4, 2008
Last updated
Aug 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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 244197 NY Primary

Addresses

Primary practice location

46 Schenck Ave
Apt. 2E
Great Neck, NY 11021-3642

Mailing address

46 Schenck Ave
Apt. 2E
Great Neck, NY 11021-3642
Phone (347) 782-1448

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
I20081113000023 NY Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3971662446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Internal Medicine PCGroup PAC ID 3173609591, 11 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-1353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Mount Sinai Hospital CurrentSince Jun 1, 2008 Accepting new patients
Mercy Internal Medicine PC Internal Medicine CurrentSince Feb 19, 2012 Accepting new patients
Mount Sinai Hospital CurrentSince Jun 1, 2008 Accepting new patients
Mlap Acquisition I, LLC Past Accepting new patients
Mercy Medical Center Past Accepting new patients

Locations

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

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

Networks

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

Organizations & group practices 6

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 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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1508022088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 SCHENCK AVE",
            "address_2": "APT. 2E",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213642",
            "telephone_number": "347-782-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 SCHENCK AVE",
            "address_2": "APT. 2E",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213642",
            "telephone_number": "347-782-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELIS",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "244197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.