Individual provider Active NPI

Alan Feller, D.O.

  • General Practice Physician
  • Great Neck, NY
National Provider Identifier
1730550476
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
198325 Issued in NY
Practice address
287 Northern Blvd
Suite 200
Great Neck, NY 11021-4700
Phone
(516) 487-3797
Fax
(516) 466-8356
NPI assigned
Oct 7, 2015
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 198325 NY Primary

Addresses

Primary practice location

287 Northern Blvd
Suite 200
Great Neck, NY 11021-4700

Mailing address

287 Northern Blvd
Suite 200
Great Neck, NY 11021-4700
Phone (516) 487-3797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
198325NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Feller Medical, PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1730550476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 NORTHERN BLVD",
            "address_2": "SUITE 200",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214700",
            "telephone_number": "516-487-3797",
            "fax_number": "516-466-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 NORTHERN BLVD",
            "address_2": "SUITE 200",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214700",
            "telephone_number": "516-487-3797",
            "fax_number": "516-466-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLER",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "198325",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.