NPIMap

Organization Active NPI

Diabetes & Metabolism LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Glen Cove, NY
National Provider Identifier
1528304342
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
118187 Issued in NY
Legal business name
DIABETES & METABOLISM LLC
Practice address
29 Glen Cove Ave
Suite 108
Glen Cove, NY 11542-2831
Phone
(516) 801-0170
Fax
(845) 230-6639
NPI assigned
Dec 26, 2012
Organization subpart
Yes
Parent organization
EVIDENCE-BASED MEDICINE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Authorized official

Name
Dr. Ronald J Innerfield, M.D.NPI 1063457950
Title
Sole Officer
Phone
(516) 801-0170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RE0101X 118187 NY Primary

Addresses

Primary practice location

29 Glen Cove Ave
Suite 108
Glen Cove, NY 11542-2831

Mailing address

PO Box 54
Austerlitz, NY 12017-0054
Phone (518) 392-2339

Other identifiers 2

IdentifierTypeStateIssuer
1063457950OtherNYNPI (INDIVIDUAL)
3X7921OtherNYMEDICARE PTAN

Other names 1

  • Diabetes & Metabolism PC Former legal business name

National Provider Directory

National Provider Directory
Part of
Evidence Based Medicine Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1528304342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "AUSTERLITZ",
            "state": "NY",
            "postal_code": "120170054",
            "telephone_number": "518-392-2339",
            "fax_number": "845-230-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 GLEN COVE AVE",
            "address_2": "SUITE 108",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422831",
            "telephone_number": "516-801-0170",
            "fax_number": "845-230-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES & METABOLISM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVIDENCE-BASED MEDICINE INC",
        "enumeration_date": "2012-12-26",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "INNERFIELD",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE OFFICER",
        "authorized_official_telephone_number": "516-801-0170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "118187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (INDIVIDUAL)",
            "identifier": "1063457950",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3X7921",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetes & Metabolism PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.