Individual provider Active NPI

Ambrose Vallone, MD

  • Pediatric Cardiology Physician
  • Roslyn, NY
National Provider Identifier
1750340444
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
175239 Issued in NY
Practice address
100 Port Washington Blvd
Suite 108
Roslyn, NY 11576-1353
Phone
(516) 365-3340
Fax
(516) 365-5512
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 175239 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Suite 108
Roslyn, NY 11576-1353

Mailing address

100 Port Washington Blvd
Suite 108
Roslyn, NY 11576-1353
Phone (516) 365-3340

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
I20040318000600 NY Practitioner - Cardiovascular Disease (Cardiology) 7618867045 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Johns Hopkins University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Cardiology of Li PCGroup PAC ID 3072508613, 3 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Suite 108
Roslyn, NY 11576-1347
Phone (516) 365-3340

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175239NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Ekg Interpretation, P. C. CurrentSince Dec 30, 2017 Accepting new patients
Pediatric Cardiology of Li PC Pediatric Cardiology CurrentSince Jan 1, 1995 Accepting new patients
Mercy Internal Medicine PC CurrentSince Jun 28, 2022 Accepting new patients

Locations

661 Deer Park Ave
Babylon, NY 11702
Phone (631) 376-3880

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
#108
Roslyn, NY 11576

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste 108
Roslyn, NY 11576
Phone (516) 365-3340

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1750340444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "SUITE 108",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-365-3340",
            "fax_number": "516-365-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "SUITE 108",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-365-3340",
            "fax_number": "516-365-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLONE",
        "first_name": "AMBROSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "175239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.