NPIMap

Individual provider Active NPI

Niranjan Gunasekaran, D.O.

  • Nephrology Physician
  • Bethpage, NY
National Provider Identifier
1598108185
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
286211 Issued in NY
Practice address
4250 Hempstead Tpke Ste 17
Bethpage, NY 11714-5707
Phone
(516) 735-5522
NPI assigned
Apr 12, 2013
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS14133 FL
Nephrology Physician 207RN0300X 286211 NY Primary
Hospitalist Physician 208M00000X 143357 IL

Addresses

Primary practice location

4250 Hempstead Tpke Ste 17
Bethpage, NY 11714-5707

Mailing address

4250 Hempstead Tpke
Ste 17
Bethpage, NY 11714-5707
Phone (516) 735-5522

Other practice location 1

2001 W 68th St
GME office
Hialeah, FL 33016
Phone (305) 823-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170126001208 MO Practitioner - Internal Medicine 5092008904 Reassigns benefits to 1 organization
I20170310000214 NY Practitioner - NephrologyPractitioner - Internal Medicine 5092008904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Kidney Associates, PCGroup PAC ID 0345426284, 4 clinicians

Practice addresses (Care Compare)

4250 Hempstead Tpke
Suite 17
Bethpage, NY 11714-5707
Phone (516) 735-5522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
52.63 of 100Reported as individual
Quality
56.69
Improvement activities
0
Cost
68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS14133FLMDInternal Medicine Physician
143357ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC Single Specialty CurrentSince Feb 13, 2017 Accepting new patients
Long Island Kidney Associates, PC Single Specialty CurrentSince Nov 10, 2019 Accepting new patients
United Medical Associates, P.C. CurrentSince Feb 13, 2017 Accepting new patients
Butler Physician Services, LLC Single Specialty CurrentSince Dec 21, 2016 Accepting new patients
SPS Medical PC Single Specialty PastSince Jul 25, 2019 Accepting new patients

Locations

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

4250 Hempstead Tpke
Ste 17
Bethpage, NY 11714
Phone (516) 731-5070

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1598108185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 HEMPSTEAD TPKE",
            "address_2": "STE 17",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145707",
            "telephone_number": "516-735-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 HEMPSTEAD TPKE STE 17",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145707",
            "telephone_number": "516-735-5522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 68th St",
            "address_2": "GME office",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "33016",
            "country_code": "US",
            "telephone_number": "305-823-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNASEKARAN",
        "first_name": "NIRANJAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS14133",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "286211",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "143357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.