Active NPI
Amory Vedran Novoselac, M.D.
- Hematology & Oncology Physician
- New York, NY
National Provider Identifier
1699852962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 252245
- Practice address
- 12 E 86TH St
Ofc 4
New York, NY 10028-0506 - Phone
- (212) 861-6660
- Fax
- (212) 744-4696
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 252245 | NY | Primary |
| Hematology & Oncology Physician | 207RH0003X | 35084949 | OH |
Addresses
Primary practice location
12 E 86TH St
Ofc 4
New York, NY 10028-0506
Mailing address
12 E 86TH St
Ofc 4
New York, NY 10028-0506
Phone (212) 861-6660
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2589739 | Medicaid | OH | |
| 64102163 | Medicaid | KY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1500 Route 112
Port Jefferson Station, NY 11776-8054
Phone (631) 751-3000
217 Portion Rd
Ronkonkoma, NY 11779-2341
Phone (631) 751-3000
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Hematology Oncology Associates PC | Current | Accepting new patients |
Locations
210 E 86th St
New York, NY 10028
Phone (212) 583-2930
12 E 86th St
Ofc 4
New York, NY 10028
Phone (212) 861-6660
1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354
48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- anovoselac65838@northwell.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1477616571
-
- General Acute Care Hospital
- Long Island City, NY
- NPI 1245248939
-
- Rehabilitation Hospital
- New York, NY
- NPI 1669440327
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- General Acute Care Hospital
- New York, NY
- NPI 1225295512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1699852962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 E 86TH ST",
"address_2": "OFC 4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100280506",
"telephone_number": "212-861-6660",
"fax_number": "212-744-4696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 E 86TH ST",
"address_2": "OFC 4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100280506",
"telephone_number": "212-861-6660",
"fax_number": "212-744-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVOSELAC",
"first_name": "AMORY",
"middle_name": "VEDRAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "NY",
"license": "252245",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "OH",
"license": "35084949",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2589739",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64102163",
"state": "KY"
}
],
"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 May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.