NPIMap

Organization Active NPI

New York University

Doing business as NYU Langone Ambulatory Care - Bethpage

  • Internal Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1760155204
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NEW YORK UNIVERSITY
Doing business as
NYU Langone Ambulatory Care - Bethpage
Practice address
3301 Quantum Blvd
Boynton Beach, FL 33426-8668
Phone
(877) 648-2964
NPI assigned
Jul 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Andrew T. Rubin
Title
Sr. VP Clinical Affairs, Amb Care
Phone
(212) 263-2672

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

3301 Quantum Blvd
Boynton Beach, FL 33426-8668

Mailing address

185 Central Ave
Bethpage, NY 11714-3927
Phone (516) 758-8600

Other practice location 1

185 Central Ave
Bethpage, NY 11714-3927
Phone (516) 758-8600

Other names 1

  • NYU Langone Ambulatory Care - Bethpage Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210817000701 NY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1355232422 Practice locations: Bethpage, NY

National Provider Directory

National Provider Directory
Tax ID family
Dr J Thomas Roland105 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NYU Langone HospitalsNew York, NY, CCN 330214 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone Hospitals Psychiatric UnitNew York, NY, CCN 33S214 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone HospitalsMineola, NY, CCN 33021401 Hospital Operational/Managerial Control Aug 1, 2019
NYU Langone Amb Care CommackGarden City, NY, CCN 337187 Home health agency Operational/Managerial Control Apr 1, 2015

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1760155204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 CENTRAL AVE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143927",
            "telephone_number": "516-758-8600",
            "fax_number": "929-455-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 QUANTUM BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268668",
            "telephone_number": "877-648-2964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Bethpage",
            "state": "NY",
            "postal_code": "117143927",
            "country_code": "US",
            "telephone_number": "516-758-8600",
            "fax_number": "929-455-9773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW YORK UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "SR. VP CLINICAL AFFAIRS, AMB CARE",
        "authorized_official_telephone_number": "212-263-2672"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYU Langone Ambulatory Care - Bethpage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NYU Langone Ambulatory Care - Bethpage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.