Individual provider Active NPI

Ross Eliott Lipton, M.D.

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Port Jefferson, NY
National Provider Identifier
1518256767
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X
License
202189 Issued in NY
Practice address
635 Belle Terre Rd Ste 209
Port Jefferson, NY 11777
Phone
(631) 474-0707
Fax
(631) 474-4034
NPI assigned
Mar 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine Physician 204R00000X 202189 NY
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 202189 NY
Neurology Physician 2084N0400X 202189 NY
Interventional Pain Medicine Physician 208VP0014X 202189 NY
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 202189 NY Primary

Addresses

Primary practice location

635 Belle Terre Rd Ste 209
Port Jefferson, NY 11777

Mailing address

635 Belle Terre Rd Ste 209
Port Jefferson, NY 11777-1935
Phone (631) 474-0707

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
I20121119000154 NY Practitioner - Family Practice 9739330861 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Physician Associates, PLLC CurrentSince Apr 18, 2018 Accepting new patients
True North Medical at North Suffolk PLLC Neurology CurrentSince Nov 1, 2022 Accepting new patients
Neurological Regional Associates, P.a. Neurology Past Accepting new patients
Wasatch Neurological Clinic Neurology Past Accepting new patients

Locations

635 Belle Terre Rd
Ste 209
Port Jefferson, NY 11777
Phone (631) 503-1400

5 Medical Dr
Port Jefferson Station, NY 11776
Phone (631) 364-9119

1010 Route 112
Ste 300
Port Jefferson Station, NY 11776
Phone (631) 364-9119

70 N Country Rd
Ste 203
Prt Jefferson, NY 11777
Phone (631) 744-3611

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1518256767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD STE 209",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771935",
            "telephone_number": "631-474-0707",
            "fax_number": "631-474-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD STE 209",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11777",
            "telephone_number": "631-474-0707",
            "fax_number": "631-474-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTON",
        "first_name": "ROSS",
        "middle_name": "ELIOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NY",
            "license": "202189",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NY",
            "license": "202189",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "202189",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "202189",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NY",
            "license": "202189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.