NPIMap

Organization Active NPI

New York Institute of Technology

  • Family Medicine Physician
  • Old Westbury, NY
National Provider Identifier
1821048612
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEW YORK INSTITUTE OF TECHNOLOGY
Practice address
600 Northern Blvd
Academic Health Care Center-Ny Institute of Technology
Old Westbury, NY 11568-8000
Phone
(516) 686-1300
Fax
(516) 686-7890
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Eddy Charles
Title
Associate Director
Phone
(516) 686-4969

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

600 Northern Blvd
Academic Health Care Center-Ny Institute of Technology
Old Westbury, NY 11568-8000

Mailing address

600 Northern Blvd
Academic Health Care Center-Ny Institute of Technology
Old Westbury, NY 11568-8000
Phone (516) 686-1300

Other identifiers 2

IdentifierTypeStateIssuer
W05883OtherNYMEDICARE GROUP NUMBER
1821048612OtherNYGROUP NPI NUMBER

Other names 1

  • Academic Health Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000454 NY Part B Supplier - Clinic/Group Practice 3779496039 Receives reassigned benefits from 53 practitioners
1 other NPI on this enrollment
Practice locations: Bronx, NY; Central Islip, NY; Greenvale, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

16 Atlantic Ave
Lynbrook, NY 11563

Practitioners & affiliated clinicians

Practitioners 70

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1821048612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER-NY INSTITUTE OF TECHNOLOGY",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER-NY INSTITUTE OF TECHNOLOGY",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK INSTITUTE OF TECHNOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "EDDY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "516-686-4969"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "W05883",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1821048612",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Academic Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.