Individual provider Active NPI

Michael Ohebshalom, MD

  • Urology Physician
  • Manhasset, NY
National Provider Identifier
1568599447
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
228138 Issued in NY
Practice address
315 E Shore Rd
Manhasset, NY 11030-2923
Phone
(516) 487-5577
Fax
(516) 487-2947
NPI assigned
Feb 27, 2007
Last updated
Dec 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 228138 NY
Urology Physician 208800000X 228138 NY Primary

Addresses

Primary practice location

315 E Shore Rd
Manhasset, NY 11030-2923

Mailing address

315 E Shore Rd
Manhasset, NY 11030-2923
Phone (516) 487-5577

Other practice location 1

6902 Austin St Fl 3
Forest Hills, NY 11375-4233
Phone (718) 544-4443

Other identifiers 2

IdentifierTypeStateIssuer
04172HOtherNYGHI MEDICARE
02866177MedicaidNY

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
I20070720000596 NY Practitioner - Urology 1951401058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
JS Weill Medical College, Cornell University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

1 Delaware Dr
Suite 101
New Hyde Park, NY 11042-1116
Phone (631) 751-3000

365 E Main St
Patchogue, NY 11772-3145
Phone (631) 751-3000

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dimitri N Kessaris MDPC Urology CurrentSince Jul 1, 2007 Accepting new patients
North Shore Hematology Oncology Associates PC Specialist CurrentSince Feb 1, 2024 Accepting new patients

Locations

6902 Austin St
Forest Hills, NY 11375
Phone (516) 423-6141

6902 Austin St
Fl 3
Forest Hills, NY 11375
Phone (718) 544-4443

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

315 E Shore Rd
Manhasset, NY 11030
Phone (516) 773-6611

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1568599447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E SHORE RD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110302923",
            "telephone_number": "516-487-5577",
            "fax_number": "516-487-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E SHORE RD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110302923",
            "telephone_number": "516-487-5577",
            "fax_number": "516-487-2947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6902 Austin St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113754233",
            "country_code": "US",
            "telephone_number": "718-544-4443",
            "fax_number": "516-487-2947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OHEBSHALOM",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "228138",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "228138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "04172H",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02866177",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.