NPIMap

Organization Active NPI

North Shore Lij Internal Medicine at New Hyde Park PC

  • Pulmonary Disease Physician
  • New Hyde Park, NY
National Provider Identifier
1821438656
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
NORTH SHORE LIJ INTERNAL MEDICINE AT NEW HYDE PARK PC
Practice address
3003 New Hyde Park Rd
Suite 303
New Hyde Park, NY 11042-1206
Phone
(516) 326-0707
Fax
(516) 326-1101
NPI assigned
Jun 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Mrs. Michele Cusak
Title
Cfo
Phone
(516) 465-8162

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

3003 New Hyde Park Rd
Suite 303
New Hyde Park, NY 11042-1206

Mailing address

972 Brush Hollow Rd
Finance 5TH Floor
Westbury, NY 11590-1740
Phone (516) 876-6065

Other names 1

  • North Shore - LIJ Medical Group at Nassau Queens Pulmonary Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140514001627 NY Part B Supplier - Clinic/Group Practice 0648493908 Receives reassigned benefits from 8 practitioners
Practice locations: Manhasset, NY; Woodbury, NY; New Hyde Park, NY; Howard Beach, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1821438656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "address_2": "FINANCE 5TH FLOOR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-6065",
            "fax_number": "516-876-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD",
            "address_2": "SUITE 303",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421206",
            "telephone_number": "516-326-0707",
            "fax_number": "516-326-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE LIJ INTERNAL MEDICINE AT NEW HYDE PARK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "CUSAK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-465-8162",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore - LIJ Medical Group at Nassau Queens Pulmonary",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "North Shore - LIJ Medical Group at Nassau Queens Pulmonary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.