NPIMap

Individual provider Active NPI

Yuval Hiltzik, D.O.

  • Pulmonary Disease Physician
  • Port Jefferson Station, NY
National Provider Identifier
1518102607
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
247268 Issued in NY
Practice address
1500 Route 112 Ste B
Port Jefferson Station, NY 11776-8055
Phone
(631) 978-7633
Fax
(631) 621-4115
NPI assigned
Dec 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247268 NY
Pulmonary Disease Physician 207RP1001X 247268 NY Primary

Addresses

Primary practice location

1500 Route 112 Ste B
Port Jefferson Station, NY 11776-8055

Mailing address

500 Commack Rd
Commack, NY 11725-5020
Phone (631) 675-2125

Other practice location 1

47 Commerce Ave Ste 1
Riverhead, NY 11901-3106
Phone (631) 978-7633

Other practice location 2

200 Motor Pkwy
Hauppauge, NY 11788-5100
Phone (631) 978-7633

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
I20090320000325 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 4981761871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
New York College of Osteo Medicine of New York Institute of Technology, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

1300 Roanoke Ave
Riverhead, NY 11901-2031
Phone (631) 548-6000

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Pulmonary Disease CurrentSince May 14, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince May 14, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

200 Motor Pkwy
Hauppauge, NY 11788
Phone (631) 234-5666

1500 Route 112
Ste B
Port Jefferson Station, NY 11776
Phone (631) 343-4184

75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

47 Commerce Ave
Ste 1
Riverhead, NY 11901
Phone (631) 978-7633

100 Nicolls Rd
#13202
Stony Brook, NY 11794

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: yuval.hiltzik@sbcm.cernerdirect.com

Organizations & group practices 3

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 9

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": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1518102607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255020",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055",
            "telephone_number": "631-978-7633",
            "fax_number": "631-621-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Commerce Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119013106",
            "country_code": "US",
            "telephone_number": "631-978-7633",
            "fax_number": "631-621-4115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Motor Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hauppauge",
            "state": "NY",
            "postal_code": "117885100",
            "country_code": "US",
            "telephone_number": "631-978-7633",
            "fax_number": "631-621-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILTZIK",
        "first_name": "YUVAL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-03",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247268",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "247268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.