Individual provider Active NPI

Michelene Dole, M.D.

  • Pediatrics Physician
  • East Meadow, NY
National Provider Identifier
1659332088
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
179463 Issued in NY
Practice address
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone
(516) 572-6177
Fax
(516) 572-5483
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 179463 NY Primary

Addresses

Primary practice location

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Mailing address

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 572-6177

Other identifiers 1

IdentifierTypeStateIssuer
01166958MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102000504 NY Practitioner - Pediatric Medicine 9830116425 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179463NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Aug 24, 2010 Accepting new patients
Nassau Health Care Corporation CurrentSince Aug 24, 2010 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients

Locations

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

2201 Hempstead Tpke
Fl 18
East Meadow, NY 11554
Phone (516) 572-6177

161 Hempstead Tpke
Elmont, NY 11003
Phone (516) 571-8200

460 N Main St
Freeport, NY 11520
Phone (516) 571-3410

100 Main St
Hempstead, NY 11550
Phone (516) 572-6711

615 Riverside Blvd
Long Beach, NY 11561
Phone (516) 571-7795

682 Union Ave
Westbury, NY 11590
Phone (516) 571-9500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1659332088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6177",
            "fax_number": "516-572-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6177",
            "fax_number": "516-572-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLE",
        "first_name": "MICHELENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "179463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01166958",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.