Medical Doctor Visit Me PLLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

222985 Issued in NY

Legal business name

MEDICAL DOCTOR VISIT ME PLLC

Practice address

570 Smith Haven Mall
Lake Grove, NY 11755-1206

Phone

(631) 338-8131

NPI assigned

Mar 25, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Pradeep Albert, MD

Title

Medical Director

Phone

(631) 338-8131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 33X0009893

Legal name

MEDICAL DOCTOR VISIT ME, PLLC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Oct 19, 2018

Last certification

Oct 19, 2018

Ownership / control type

Partnership

Facility address

4160 Merrick Road, Suite a
E Massapequa, NY 11758

Locations

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1588081889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 SMITH HAVEN MALL",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551206",
            "telephone_number": "631-338-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 SMITH HAVEN MALL",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551206",
            "telephone_number": "631-338-8131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4160 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117586000",
            "country_code": "US",
            "telephone_number": "516-797-6700",
            "fax_number": "516-797-8463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL DOCTOR VISIT ME PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "ALBERT",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "631-338-8131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "222985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Joseph McEvoy, APRN PMHNP-BC
• Maureen McKeon-Simone, RD
• Colleen McMahon
• Stephanie Mederos, RDH
• Medical Arts Radiological Group, P.C.
• Medical Spine Specialists PC
• Allison Meiselbach, MSW
• Matthew Merensky, PA-C
• Margaret Michalak, MS
• Emily Moore, MD

• Diagnostic Radiology Physician in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.