Individual provider Active NPI

Nancy Leventhal

  • Family Medicine Physician
  • Massapequa, NY
National Provider Identifier
1568827103
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1753621 Issued in NY
Practice address
1061 N Broadway
Massapequa, NY 11758-1853
Phone
(516) 420-4300
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1753621 NY Primary

Addresses

Primary practice location

1061 N Broadway
Massapequa, NY 11758-1853

Mailing address

1061 North Broadway
Massapequa, NY 11758
Phone (516) 420-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1753621NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1568827103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 NORTH BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-420-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 N BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581853",
            "telephone_number": "516-420-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENTHAL",
        "first_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "1753621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.