Organization Active NPI

Neuro Brain & Spine Surgery, P.C.

  • Neurological Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1679718670
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
NEURO BRAIN & SPINE SURGERY, P.C.
Practice address
2500 Nesconset Hwy
BLDG. 18, Suite 69
Stony Brook, NY 11790-2555
Phone
(631) 751-2700
Fax
(631) 751-5853
NPI assigned
Dec 5, 2008
Last updated
Dec 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Magdy S. Shady, M.D.NPI 1073556437
Title
Provider
Phone
(631) 751-2700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

2500 Nesconset Hwy
BLDG. 18, Suite 69
Stony Brook, NY 11790-2555

Mailing address

2500 Nesconset Hwy
BLDG. 18, Suite 69
Stony Brook, NY 11790-2555
Phone (631) 751-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090915000465 NY Part B Supplier - Clinic/Group Practice 3870649908 Receives reassigned benefits from 2 practitioners
Practice locations: Stony Brook, NY

National Provider Directory

National Provider Directory

Locations

2500 Nesconset Hwy
#69
Stony Brook, NY 11790
Phone (631) 751-2700

2500 Nesconset Hwy
Bldg 18
Stony Brook, NY 11790
Phone (631) 751-2700

2500 Route 347
Bldg 1
Stony Brook, NY 11790
Phone (631) 689-7700

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1679718670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "BLDG. 18, SUITE 69",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-2700",
            "fax_number": "631-751-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "BLDG. 18, SUITE 69",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-2700",
            "fax_number": "631-751-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO BRAIN & SPINE SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "SHADY",
        "authorized_official_first_name": "MAGDY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "631-751-2700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.