Individual provider Active NPI

Marius Leon Pessah, M.D.

  • Nephrology Physician
  • New Hyde Park, NY
National Provider Identifier
1508892274
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
114082 Issued in NY
Practice address
1575 Hillside Ave
Suite 102
New Hyde Park, NY 11040-2501
Phone
(516) 437-1616
Fax
(516) 354-6048
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 114082 NY Primary

Addresses

Primary practice location

1575 Hillside Ave
Suite 102
New Hyde Park, NY 11040-2501

Mailing address

1575 Hillside Ave
Suite 102
New Hyde Park, NY 11040-2501
Phone (516) 437-1616

Other identifiers 8

IdentifierTypeStateIssuer
41791OtherNYVYTRA
46599OtherNYMDNY
11A39OtherNYEMPIRE BLUE SHIELD
112458161OtherNY1199 NATIONAL BENEFIT FUN
5504617001OtherNYCIGNA
AS807OtherNYOXFORD
2C8020OtherNYHEALTHNET
1532050OtherNYUNITED HEALTHCARE

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
I20080228000203 NY Practitioner - Internal MedicinePractitioner - Nephrology 9739271156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 876-5555

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
New Hyde Park Internal Medicine Specialists, P.C. Nephrology PastSince Jul 1, 1979 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

1575 Hillside Ave
Ste 102
New Hyde Park, NY 11040
Phone (516) 354-3400

1575 Hillside Ave
North New Hyde Pk, NY 11040
Phone (516) 200-1835

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: mariuspessah@nslijmedgr.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1508892274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE",
            "address_2": "SUITE 102",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "516-437-1616",
            "fax_number": "516-354-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE",
            "address_2": "SUITE 102",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "516-437-1616",
            "fax_number": "516-354-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSAH",
        "first_name": "MARIUS",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "114082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "41791",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "46599",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE SHIELD",
            "identifier": "11A39",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199 NATIONAL BENEFIT FUN",
            "identifier": "112458161",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5504617001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "AS807",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C8020",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1532050",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.