Organization Active NPI

Gastroenterology Consultants of Long Island, PC

  • Gastroenterology Physician
  • New Hyde Park, NY
National Provider Identifier
1730120536
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY CONSULTANTS OF LONG ISLAND, PC
Practice address
2001 Marcus Ave
Suite E240
New Hyde Park, NY 11042-2061
Phone
(516) 673-4801
Fax
(516) 352-3680
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Authorized official

Name
Dr. John M Costable, MD
Title
President
Phone
(516) 673-4801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

2001 Marcus Ave
Suite E240
New Hyde Park, NY 11042-2061

Mailing address

2001 Marcus Ave
Suite E240
New Hyde Park, NY 11042-2061
Phone (516) 673-4801

Other names 1

  • JOHN M COSTABLE MD, PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070305000477 NY Part B Supplier - Clinic/Group Practice 0840236774 Receives reassigned benefits from 4 practitioners
Practice locations: New Hyde Park, 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
33D1024764Gastroenterology Consultants of Long Island, PC2001 Marcus Ave, Suite E240, New Hyde Park, NY 11042ComplianceJan 2, 2028

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3699/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389916800000",
    "number": "1730120536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE E240",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422061",
            "telephone_number": "516-673-4801",
            "fax_number": "516-352-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE E240",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422061",
            "telephone_number": "516-673-4801",
            "fax_number": "516-352-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY CONSULTANTS OF LONG ISLAND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2014-01-17",
        "status": "A",
        "authorized_official_last_name": "COSTABLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-673-4801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHN M COSTABLE MD, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; 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.