Individual provider Active NPI

Andrea Zimmern, M.D.

  • Surgery Physician
  • Hicksville, NY
National Provider Identifier
1669641296
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
237987 Issued in NY
Practice address
350 S Broadway
Hicksville, NY 11801-5006
Phone
(646) 680-2888
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 237987 NY Primary
Colon & Rectal Surgery Physician 208C00000X 237987 NY

Addresses

Primary practice location

350 S Broadway
Hicksville, NY 11801-5006

Mailing address

441 9TH Ave
3Rd Floor
New York, NY 10001-1623
Phone (646) 680-2888

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
I20160831001295 NY Practitioner - Colorectal Surgery (Proctology) 5092973545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
New York Medical College, 2004
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)

900 Northern Blvd
Suite 100
Great Neck, NY 11021-5302
Phone (516) 730-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy51
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237987NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Colon & Rectal Surgery CurrentSince Feb 13, 2017 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 13, 2017 Accepting new patients
North Shore University Hospital Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

900 Northern Blvd
Ste 100
Great Neck, NY 11021
Phone (516) 730-2100

1991 Marcus Ave
North New Hyde Park, NY 11042
Phone (516) 200-0025

300 Community Dr
Plandome, NY 11030

36 Lincoln Ave
Rockville Ctr, NY 11570
Phone 5165362800121

106 Charles Lindbergh Blvd
#B
Uniondale, NY 11553

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: azimmern290366@northwell.direct-ci.com

Organizations & group practices 4

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 4

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1669641296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 9TH AVE",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011623",
            "telephone_number": "646-680-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015006",
            "telephone_number": "646-680-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERN",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "237987",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "237987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.