Individual provider Active NPI

Lee Smith, M.D.

  • Pediatric Otolaryngology Physician
  • New Hyde Park, NY
National Provider Identifier
1790984987
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
521533 Issued in NY
Practice address
430 Lakeville Rd
New Hyde Park, NY 11042-1121
Phone
(516) 470-7550
Fax
(516) 470-4514
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 521533 NY Primary
Otolaryngology Physician 207Y00000X 251533 NY

Addresses

Primary practice location

430 Lakeville Rd
New Hyde Park, NY 11042-1121

Mailing address

430 Lakeville Rd
New Hyde Park, NY 11042-1121
Phone (516) 470-7550

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
I20090701000232 NY Practitioner - Otolaryngology 2264583350 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251533NYMDOtolaryngology Physician
521533NYMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Otolaryngology CurrentSince Jul 1, 2012 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

100 Community Dr
Great Neck, NY 11021
Phone (516) 365-1805

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

430 Lakeville Rd
North New Hyde Park, NY 11042
Phone (718) 470-7550

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

222 E Middle Country Rd
Ste 106
Smithtown, NY 11787
Phone (631) 439-5437

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: leesmith@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1790984987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421121",
            "telephone_number": "516-470-7550",
            "fax_number": "516-470-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421121",
            "telephone_number": "516-470-7550",
            "fax_number": "516-470-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NY",
            "license": "521533",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "251533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.