North Shore Medical Group of Mount Sinai School of Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

157830 Issued in NY

Legal business name

NORTH SHORE MEDICAL GROUP OF MOUNT SINAI SCHOOL OF MEDICINE

Practice address

521 Route 111
Suite 202
Hauppauge, NY 11788-4370

Phone

(631) 361-4625

Fax

(631) 361-2021

NPI assigned

Nov 12, 2009

Organization subpart

No

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

Authorized official

Name

Janet Street

Title

Administrator

Phone

(631) 351-3703

Specialties & licenses 2

Addresses

Other names 1

• North Shore Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• North Shore Medical Group of Mt Sinai School of Medicine

  • Pediatric Urology Physician
  • Huntington, NY
  • NPI 1639317043

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Commack, NY
  • NPI 1144431701

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Gastroenterology Physician
  • Huntington, NY
  • NPI 1164623278

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Greenlawn, NY
  • NPI 1275640609

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Dermatology Physician
  • Huntington, NY
  • NPI 1649382532

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Body Imaging Physician
  • Huntington, NY
  • NPI 1902918899

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Gastroenterology Physician
  • Nesconset, NY
  • NPI 1962646091

  O20040320000412

  Same enrollment
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Wantagh, NY
  • NPI 1992417323

  O20040320000412

  Same enrollment

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1811224868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 ROUTE 111",
            "address_2": "SUITE 202",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884370",
            "telephone_number": "631-361-4625",
            "fax_number": "631-361-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ROUTE 111",
            "address_2": "SUITE 202",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884370",
            "telephone_number": "631-361-4625",
            "fax_number": "631-361-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE MEDICAL GROUP OF MOUNT SINAI SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-351-3703"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "157830",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "159827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diandra Nicholas
• Jack Niemiec, RN
• James Nixon
• Deannie Noboa, M.A., CCC-SLP TSSLD
• Ryan Nordin, LCSW
• North Shore Psychology
• Montana Len Northcutt, CNIM
• Northfield Family Medicine, P.C.
• Stephanie Natalie Nunez, MHC-LP
• Sandra Nwangwu

• All providers in Hauppauge, NY
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.