Individual provider Active NPI

Debbie Feliciano, MD

  • Family Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1710064761
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
243930 Issued in NY
Practice address
104 Forest Ave
Glen Cove, NY 11542-2015
Phone
(516) 759-5406
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35088229 OH
Family Medicine Physician 207Q00000X 243930 NY Primary

Addresses

Primary practice location

104 Forest Ave
Glen Cove, NY 11542-2015

Mailing address

104 Forest Ave
Glen Cove, NY 11542-2015
Phone (516) 759-5406

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
I20080501000407 NY Practitioner - Family PracticePractitioner - General Practice 3870594823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

480 Forest Ave
Suite 403
Locust Valley, NY 11560-2152
Phone (516) 759-5406

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35088229OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical Station of North Shore PC Family Medicine CurrentSince Jan 8, 2018 Accepting new patients
The Medical Station of Long Island PC CurrentSince Oct 2, 2022 Accepting new patients
Emergency Medicine Group Past Accepting new patients

Locations

480 Forest Ave
Ste 403
Locust Valley, NY 11560
Phone (516) 759-5406

480 Forest Ave
Locust Valley, NY 11560
Phone (510) 472-2541

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: debbiefeliciano@tms.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1325030400000",
    "number": "1710064761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FOREST AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422015",
            "telephone_number": "516-759-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FOREST AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422015",
            "telephone_number": "516-759-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "DEBBIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35088229",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.