Individual provider Active NPI

Eric Ballecer

  • Gastroenterology Physician
  • Greenlawn, NY
National Provider Identifier
1760833602
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
300758 Issued in NY
Practice address
5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone
(631) 628-5000
NPI assigned
Jun 22, 2016
Last updated
May 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Gastroenterology Physician 207RG0100X 300758 NY Primary

Addresses

Primary practice location

5 Cuba Hill Rd
Greenlawn, NY 11740-1624

Mailing address

6986 N Glen Shore Dr
Glendale, WI 53209-2841
Phone (414) 759-7000

Other practice location 1

222 Station Plz N Ste 509
Mineola, NY 11501-3893
Phone (516) 663-2381

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
I20220803003268 NY Practitioner - Gastroenterology 6507248739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone (631) 628-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy223
Upper gastrointestinal (GI) endoscopy for acid reflux123

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Gastroenterology CurrentSince Aug 26, 2022 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Gastroenterology CurrentSince Aug 26, 2022 Accepting new patients

Locations

5 Cuba Hill Rd
Greenlawn, NY 11740
Phone (631) 628-5000

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

61 Southern Blvd
Nesconset, NY 11767
Phone (631) 659-1800

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1760833602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6986 N GLEN SHORE DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532092841",
            "telephone_number": "414-759-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CUBA HILL RD",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401624",
            "telephone_number": "631-628-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Station Plz N Ste 509",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115013893",
            "country_code": "US",
            "telephone_number": "516-663-2381",
            "fax_number": "516-663-8796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLECER",
        "first_name": "ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "300758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenlawn, NY

Sources for this page

Verify at the official NPI Registry.