Individual provider Active NPI

Howard L Knoll, DO

  • Internal Medicine Physician
  • Massapequa, NY
National Provider Identifier
1700994589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
175948 Issued in NY
Practice address
896 N Broadway
Massapequa, NY 11758-2328
Phone
(516) 798-5552
Fax
(516) 541-2456
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 175948 NY Primary

Addresses

Primary practice location

896 N Broadway
Massapequa, NY 11758-2328

Mailing address

896 N Broadway
Massapequa, NY 11758-2328
Phone (516) 798-5552

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
I20111101000571 NY Practitioner - Family Practice 0749453090 Practice locations: Massapequa, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175948NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700994589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 N BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582328",
            "telephone_number": "516-798-5552",
            "fax_number": "516-541-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 N BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582328",
            "telephone_number": "516-798-5552",
            "fax_number": "516-541-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOLL",
        "first_name": "HOWARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.