Mitchell Peterson Creed, MD
Individual provider Active NPI Neurology with Special Qualifications in Child Neurology Physician · Islip, NY
NPI 1659831121 · NPPES record last updated Jun 30, 2025
Key facts
- NPI
- 1659831121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician 2084N0402X
- License
- 331351 (NY)
- Practice address
- 712 Main St
Islip, NY 11751-3620 - Phone
- (631) 666-3939
- NPI assigned
- Mar 21, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250623001776 | NY | Practitioner - Neurology | 9032445739 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331351 | NY | MD | Epilepsy Physician |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current |
Accepting new patients | |
| New York University | Current |
Accepting new patients |
Locations
700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325
712 Main St
Islip, NY 11751
Phone (631) 666-3939
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- mcreed722519@nyumc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Epilepsy Physician | 2084E0001X | 331351 | NY | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 331351 | NY | Yes |
Addresses
Primary practice location
712 Main St
Islip, NY 11751-3620
Mailing address
605 Sylvan Ave
Bayport, NY 11705-1540
Phone (913) 544-6647
Other providers in Islip, NY
- Veronica Carolina Cordova
- Hally Corrao
- Jennifer Cortez
- Thomas Joseph Courtney
- Denise Maria Crean
- Crossroads Physical Therapy
- Maggie Anne Cullen
- Lisamarie Curley
- Andrea C Cuttler
- Michael John D'Arienzo
All providers in Islip, NY · Neurology with Special Qualifications in Child Neurology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.