Organization Active NPI

North Nassau Endocrinology and Diabetes PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Great Neck, NY
National Provider Identifier
1710033931
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
203765 Issued in NY
Legal business name
NORTH NASSAU ENDOCRINOLOGY AND DIABETES PLLC
Practice address
1000 Northern Blvd
Suite 240
Great Neck, NY 11021-5312
Phone
(516) 829-0802
Fax
(516) 487-9433
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jonathan Kaplan, M.D.NPI 1285713487
Title
Ceo, President
Phone
(516) 829-0802

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
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 203765 NY Primary

Addresses

Primary practice location

1000 Northern Blvd
Suite 240
Great Neck, NY 11021-5312

Mailing address

1000 Northern Blvd
Suite 240
Great Neck, NY 11021-5312
Phone (516) 829-0802

Other identifiers 1

IdentifierTypeStateIssuer
01875938MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070519000029 NY Part B Supplier - Clinic/Group Practice 1456458850 Receives reassigned benefits from 1 practitioner
Practice locations: Great Neck, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1065817North Nassau Endocrinology1000 Northern Blvd, Great Neck, NY 11021Certificate of waiverMar 8, 2027

National Provider Directory

National Provider Directory

Locations

1000 Northern Blvd
Ste 112
Great Neck, NY 11021
Phone (516) 829-0802

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710033931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 240",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-829-0802",
            "fax_number": "516-487-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 240",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-829-0802",
            "fax_number": "516-487-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH NASSAU ENDOCRINOLOGY AND DIABETES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAPLAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "516-829-0802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "203765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01875938",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.