NPIMap

Individual provider Active NPI

Jeffrey Nakhjavan, D.O.

  • Internal Medicine Physician
  • North Babylon, NY
National Provider Identifier
1578676136
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
216089 Issued in NY
Practice address
1400 Deer Park Ave
North Babylon, NY 11703-1618
Phone
(631) 242-1181
Fax
(631) 242-1372
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 216089 NY Primary

Addresses

Primary practice location

1400 Deer Park Ave
North Babylon, NY 11703-1618

Mailing address

760 Sunrise Hwy
West Babylon, NY 11704-6014
Phone (631) 242-1181

Other identifiers 1

IdentifierTypeStateIssuer
02187300MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100326000125 NY Practitioner - Family Practice 6608902960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

760 Sunrise Hwy
West Babylon, NY 11704-6014
Phone (631) 242-1181

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey M Nakhjavan DO PC CurrentSince Feb 10, 2010 Accepting new patients
Good Samaritan Hospital Medical Center Past Accepting new patients

Locations

1400 Deer Park Ave
North Babylon, NY 11703
Phone (631) 242-1181

760 Sunrise Hwy
West Babylon, NY 11704
Phone (631) 242-1181

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • 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 and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1578676136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 SUNRISE HWY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046014",
            "telephone_number": "631-242-1181",
            "fax_number": "631-242-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031618",
            "telephone_number": "631-242-1181",
            "fax_number": "631-242-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKHJAVAN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "216089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

Verify at the official NPI Registry.