Organization Active NPI

Long Island Plastic Surgical Group, PC

  • Specialist
  • Garden City, NY
National Provider Identifier
1821164526
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LONG ISLAND PLASTIC SURGICAL GROUP, PC
Practice address
999 Franklin Ave
Garden City, NY 11530-2913
Phone
(516) 742-3404
Fax
(516) 294-6942
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roger L Simpson, M.D.NPI 1861460552
Title
President
Phone
(516) 742-3404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X NY Primary

Addresses

Primary practice location

999 Franklin Ave
Garden City, NY 11530-2913

Mailing address

999 Franklin Ave
Garden City, NY 11530-2913
Phone (516) 742-3404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051121000765 NY Part B Supplier - Clinic/Group Practice 1153340054 Receives reassigned benefits from 58 practitioners
Practice locations: Garden City, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2053677Long Island Plastic Surgical Group, PC999 Franklin Avenue, Garden City, NY 11530Certificate of waiverFeb 4, 2027

National Provider Directory

National Provider Directory

Locations

200A W Main St
Ste 101
Babylon, NY 11702

999 Franklin Ave
#3544
Garden City, NY 11530
Phone (516) 742-3404

5316 Nesconset Hwy
Port Jefferson Station, NY 11776
Phone (631) 689-7800

Practitioners & affiliated clinicians

Practitioners 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821164526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302913",
            "telephone_number": "516-742-3404",
            "fax_number": "516-294-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302913",
            "telephone_number": "516-742-3404",
            "fax_number": "516-294-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND PLASTIC SURGICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-742-3404",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.