NPIMap

Individual provider Active NPI

Gary J Shore, M.D.

  • Internal Medicine Physician
  • Merrick, NY
National Provider Identifier
1659354942
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
179490 Issued in NY
Practice address
31 Merrick Ave
Suite 230
Merrick, NY 11566-3477
Phone
(516) 377-2820
Fax
(516) 378-2968
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 179490 NY Primary

Addresses

Primary practice location

31 Merrick Ave
Suite 230
Merrick, NY 11566-3477

Mailing address

87 E Lexington Ave
Oceanside, NY 11572-5420
Phone (516) 377-2820

Other identifiers 1

IdentifierTypeStateIssuer
01432833MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000285 NY Practitioner - Internal Medicine 5294886453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3991

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Tender Loving Care, an Amedisys Company Home health agency, Carle Place, NY, CCN 337143
  • Emerest Home Health Care of Long Island Home health agency, Flushing, NY, CCN 337189
  • Mt. Sinai at Home Home health agency, Westbury, NY, CCN 337246
  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jan 14, 2019 Accepting new patients

Locations

900 Northern Blvd
Great Neck, NY 11021
Phone (516) 482-1100

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: garyshore@nslijmedgr.allscriptsdirect.net

Organizations & group practices 1

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.

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271721600000",
    "number": "1659354942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 E LEXINGTON AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725420",
            "telephone_number": "516-377-2820",
            "fax_number": "516-378-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MERRICK AVE",
            "address_2": "SUITE 230",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663477",
            "telephone_number": "516-377-2820",
            "fax_number": "516-378-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "GARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2010-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "179490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01432833",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.