Individual provider Active NPI

Ronald Steven Levandusky, MD

  • Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1588703193
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
111867-1 Issued in NY
Practice address
2 5TH Ave
Suite 6
New York, NY 10011-8856
Phone
(212) 889-6999
Fax
(212) 473-7856
NPI assigned
Feb 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 111867-1 NY Primary

Addresses

Primary practice location

2 5TH Ave
Suite 6
New York, NY 10011-8856

Mailing address

2 5TH Ave
Suite 6
New York, NY 10011-8856
Phone (212) 889-6999

Other identifiers 1

IdentifierTypeStateIssuer
00331700MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
111867-1NYMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Menikoff MD PC PastSince Mar 15, 2008 Accepting new patients
BB Medical and Dermatology Inc Past Accepting new patients

Organizations & group practices 3

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588703193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 5TH AVE",
            "address_2": "SUITE 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118856",
            "telephone_number": "212-889-6999",
            "fax_number": "212-473-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 5TH AVE",
            "address_2": "SUITE 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118856",
            "telephone_number": "212-889-6999",
            "fax_number": "212-473-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVANDUSKY",
        "first_name": "RONALD",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "111867-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00331700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.