NPIMap

Organization Active NPI

Neurological Associates of Long Island, PC

  • Neurology Physician
  • Lake Success, NY
National Provider Identifier
1629013495
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGICAL ASSOCIATES OF LONG ISLAND, PC
Practice address
1991 Marcus Avenue
Suite 110
Lake Success, NY 11042-2057
Phone
(516) 466-4700
Fax
(516) 466-4810
NPI assigned
Jun 17, 2006
Last updated
Feb 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Authorized official

Name
Mrs. Erika L Koretz
Title
Office Administrator
Phone
(516) 466-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

1991 Marcus Avenue
Suite 110
Lake Success, NY 11042-2057

Mailing address

1991 Marcus Avenue
Suite 110
Lake Success, NY 11042-2057
Phone (516) 466-4700

Other identifiers 1

IdentifierTypeStateIssuer
41996OtherNYAETNA INS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000405 NY Part B Supplier - Clinic/Group Practice 9234028788 Receives reassigned benefits from 16 practitioners
Practice locations: New Hyde Park, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2152870Neurological Associates of Long Island PC1991 Marcus Avenue - Ste 110, Lake Success, NY 11042Certificate of waiverAug 16, 2026

National Provider Directory

National Provider Directory

Locations

1991 Marcus Ave
Ste 110
New Hyde Park, NY 11042
Phone (516) 365-8086

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1629013495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVENUE",
            "address_2": "SUITE 110",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-466-4700",
            "fax_number": "516-466-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVENUE",
            "address_2": "SUITE 110",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-466-4700",
            "fax_number": "516-466-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL ASSOCIATES OF LONG ISLAND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "KORETZ",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "516-466-4700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INS",
            "identifier": "41996",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Success, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.