Individual provider Active NPI

Eduard Bover, D.O.

  • Nephrology Physician
  • Mineola, NY
National Provider Identifier
1801831763
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
231401 Issued in NY
Practice address
300 Old Country Rd
Suite 111
Mineola, NY 11501-4198
Phone
(516) 745-0500
Fax
(516) 745-1534
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 231401 NY Primary

Addresses

Primary practice location

300 Old Country Rd
Suite 111
Mineola, NY 11501-4198

Mailing address

300 Old Country Rd
Suite 111
Mineola, NY 11501-4198
Phone (516) 745-0500

Other identifiers 1

IdentifierTypeStateIssuer
02826608MedicaidNY

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
I20061103000086 NY Practitioner - NephrologyPractitioner - Internal Medicine 6305843426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Medical Group at North Nassau, PCGroup PAC ID 7618154550, 36 clinicians
Queens Nassau Nephrology Services PLLCGroup PAC ID 5597893057, 5 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (516) 674-7460

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 496-6400

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-0100

300 Old Country Rd
Suite 111
Mineola, NY 11501-4112
Phone (516) 745-0500

70 Glen St
Suite 200
Glen Cove, NY 11542-2854
Phone (516) 484-7893

Hospital & facility affiliations

  • NYU Winthrop Hospital Dialysis Bethpage Dialysis facility, Bethpage, NY, CCN 333522
  • Davita Massapequa Dialysis Dialysis facility, Massapequa, NY, CCN 332846
  • Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Plainview Hospital Hospital, Plainview, NY, CCN 330331
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
22.56 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.2

National Provider Directory

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

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
North Shore Lij Medical Group at North Nassau, PC CurrentSince Oct 20, 2025 Accepting new patients
Queens Nassau Nephrology Services PLLC Nephrology CurrentSince Apr 1, 2013 Accepting new patients
True North Dialysis Center LLC PastSince Jul 24, 2022 Accepting new patients
True North Dialysis Center LLC Past Accepting new patients

Locations

4169 Iris Pl
Bethpage, NY 11714
Phone (516) 520-1651

877 Stewart Ave
Ste 1
Garden City, NY 11530
Phone (516) 325-7310

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

70 Glen St
Ste 200
Glen Cove, NY 11542
Phone (516) 484-7893

300 Old Country Rd
Ste 111
Mineola, NY 11501
Phone (516) 745-0500

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

22202 Hempstead Ave
Queens Village, NY 11429
Phone (516) 488-0150

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

Networks

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

Interoperability endpoints

  • Direct secure messaging: eduardbover@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.

Hospital & facility affiliations 7

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1801831763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "address_2": "SUITE 111",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014198",
            "telephone_number": "516-745-0500",
            "fax_number": "516-745-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "address_2": "SUITE 111",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014198",
            "telephone_number": "516-745-0500",
            "fax_number": "516-745-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVER",
        "first_name": "EDUARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "231401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02826608",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.