Individual provider Active NPI

Edward John Hallal Jr., MD

  • Internal Medicine Physician
  • Bay Shore, NY
National Provider Identifier
1528046422
Registry record updated Mar 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
170511 Issued in NY
Practice address
180 E Main St
Bay Shore, NY 11706-8427
Phone
(631) 665-0027
Fax
(631) 665-0172
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2010

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 170511 NY Primary

Addresses

Primary practice location

180 E Main St
Bay Shore, NY 11706-8427

Mailing address

180 E Main St
Bay Shore, NY 11706-8427
Phone (631) 665-0027

Other identifiers 1

IdentifierTypeStateIssuer
01288893MedicaidNY

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
I20091221000057 NY Practitioner - Internal Medicine 7911047121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

250 E Main St
Bay Shore, NY 11706-8402
Phone (631) 470-1540

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Hospital & facility affiliations

  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Constellation Home Care Home health agency, Syosset, NY, CCN 337447
  • Good Shepherd Hospice Hospice, Farmingdale, NY, CCN 331544
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
  • 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

State licenses

LicenseStateTypeSpecialty
170511NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Healthcare Internal Medicine CurrentSince Mar 25, 2013 Accepting new patients
North Shore Long Island Jewish Health Care Inc Internal Medicine CurrentSince Mar 25, 2013 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Feb 17, 2015 Accepting new patients

Locations

250 E Main St
Bay Shore, NY 11706
Phone (631) 390-7100

180 E Main St
Bay Shore, NY 11706
Phone (631) 665-0027

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

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

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 8

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268524800000",
    "number": "1528046422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068427",
            "telephone_number": "631-665-0027",
            "fax_number": "631-665-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068427",
            "telephone_number": "631-665-0027",
            "fax_number": "631-665-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAL",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2010-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "170511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01288893",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.