NPIMap

Organization Active NPI

Lenox Otolaryngology Head & Neck Surgery PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • New York, NY
National Provider Identifier
1689871238
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
LENOX OTOLARYNGOLOGY HEAD & NECK SURGERY PC
Practice address
366 5TH Ave RM 709
New York, NY 10001-2211
Phone
(212) 629-3223
Fax
(212) 629-3466
NPI assigned
Jun 28, 2007
Last updated
Nov 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Authorized official

Name
Mr. Michele L Cusack
Title
Senior Vice President & Cfo
Phone
(516) 321-6058

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X NU Primary
Otolaryngology Physician 207Y00000X NU
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X NU

Addresses

Primary practice location

366 5TH Ave RM 709
New York, NY 10001-2211

Mailing address

186 E 76TH St
2ND Floor
New York, NY 10021-2844
Phone (212) 434-2323

Other practice location 1

972 Brush Hollow Rd Fl 5
Westbury, NY 11590-1740
Phone (516) 876-6065

Other practice location 2

186 E 76th St
2nd Floor
New York, NY 10021-2844
Phone (212) 434-2323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326000275 NY Part B Supplier - Clinic/Group Practice 3072699479 Receives reassigned benefits from 6 practitioners
Practice locations: Bethpage, NY; New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1689871238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 E 76TH ST",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212844",
            "telephone_number": "212-434-2323",
            "fax_number": "212-434-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 5TH AVE RM 709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012211",
            "telephone_number": "212-629-3223",
            "fax_number": "212-629-3466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "972 Brush Hollow Rd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Westbury",
            "state": "NY",
            "postal_code": "115901740",
            "country_code": "US",
            "telephone_number": "516-876-6065",
            "fax_number": "516-876-5572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "186 E 76th St",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100212844",
            "country_code": "US",
            "telephone_number": "212-434-2323",
            "fax_number": "212-434-6885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LENOX OTOLARYNGOLOGY HEAD & NECK SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.