John L Kefalos, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

152638 Issued in NY

Practice address

777 Sunrise Hwy
Suite 200
Lynbrook, NY 11563-2950

Phone

(516) 887-3516

Fax

(516) 887-0331

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 16

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1619968161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SUNRISE HWY",
            "address_2": "SUITE 200",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632950",
            "telephone_number": "516-887-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SUNRISE HWY",
            "address_2": "SUITE 200",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632950",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEFALOS",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "152638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "152638",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "62259790",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE PARTNERS",
            "identifier": "640026",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "AS1069",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN,CHO  HUM,FRSTHELTH,HOR",
            "identifier": "112573413",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "68866",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AD00676",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01572861",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT PRO",
            "identifier": "NS0001847",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1917532005",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OC3470",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP NO FAULT",
            "identifier": "CPNN1526383",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAG,OHP,UHC,EMPIRE",
            "identifier": "112573413",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "3099813",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "000000056378",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Lynbrook, NY
• Providers in Lynbrook, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.