Ebenezer Premkumar Thangavelu, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F 302708-1 Issued in NY

Practice address

143 S 9TH St
Lindenhurst, NY 11757-4523

Phone

(516) 983-5754

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Long Island Medical Services P.C.Group PAC ID 3476619867, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gurwin Certified Home Health Agency Home health agency, Commack, NY, CCN 337413
• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182
• Plainview Hospital Hospital, Plainview, NY, CCN 330331

Merit-based Incentive Payment System (MIPS)

Final score

88.16 of 100Reported as individual

Quality

91.62

Improvement activities

40

Cost

51.09

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Long Island Medical Services P.C.

  • Internal Medicine Physician
  • Syosset, NY
  • NPI 1841443538
  Medicare reassignment Care Compare group
• Fulton Medical, P.C.

  • Internal Medicine Physician
  • Massapequa, NY
  • NPI 1841635133
  Medicare reassignment
• Nassau Medical Home Visits P.C.

  • Internal Medicine Physician
  • Syosset, NY
  • NPI 1104270198
  Medicare reassignment
• Hematology and Oncology of Li PLLC

  • Hematology & Oncology Physician
  • Massapequa, NY
  • NPI 1629275938
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation
• Plainview Hospital

  • General Acute Care Hospital
  • Plainview, NY
  • NPI 1083621130
  Care Compare affiliation
• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation
• The Rosalind and Joseph Gurwin Jewish Geriatric Center of Long Island

  • Skilled Nursing Facility
  • Commack, NY
  • NPI 1669472304

  Home health agency

  Care Compare affiliation
• The Rosalind and Joseph Gurwin Jewish Geriatric Center of Long Island

  • Home Health Agency
  • Commack, NY
  • NPI 1679863393
  Care Compare affiliation

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1780673228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SOUTH 9TH STREET",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "11757",
            "telephone_number": "631-957-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S 9TH ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574523",
            "telephone_number": "516-983-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANGAVELU",
        "first_name": "EBENEZER",
        "middle_name": "PREMKUMAR",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F 302708-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheryl Lynn Taylor, LCSW
• Ursula Teaster, LPN
• Jocelyne Telfort
• Olande Telusma
• Karen Terry
• The Balance Health Wellness Massage Therapy PLLC
• The Wisdom Tooth of Lindenhurst
• Thelus Specialty Care Agency LLC
• Theodora Slone LCSW LLC
• Theresa a. Schmidt, Ms,PT,PC

• Adult Health Nurse Practitioner in Lindenhurst, NY
• Providers in Lindenhurst, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.