Individual provider Active NPI

Maurice Cerulli, M.D.

  • Gastroenterology Physician
  • New Hyde Park, NY
National Provider Identifier
1831149467
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
118501 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(718) 470-7281
Fax
(718) 343-0128
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 118501 NY
Gastroenterology Physician 207RG0100X 118501 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7281

Other identifiers 1

IdentifierTypeStateIssuer
00248408MedicaidNY

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
I20081210000001 NY Practitioner - Gastroenterology 7911068929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of New York Downstate Medical Center, 1972
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16 Atlantic Ave
2ND Floor
Lynbrook, NY 11563-3046

1979 Marcus Ave
Suite C101
New Hyde Park, NY 11042-1068

972 Brush Hollow Rd
Westbury, NY 11590-1740

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118501NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
TBHC Physician Services PC Gastroenterology Past Accepting new patients
Park Slope Medical Health Provider, PC Past Accepting new patients
TBHC Medical Services PC Past Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
#400
Brooklyn, NY 11215
Phone (718) 246-8614

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

600 Northern Blvd
Ste 111
Great Neck, NY 11021
Phone (516) 387-3990

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: mauricecerulli@nslijmedgr.allscriptsdirect.net

Organizations & group practices 5

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 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1831149467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7281",
            "fax_number": "718-343-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7281",
            "fax_number": "718-343-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERULLI",
        "first_name": "MAURICE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "118501",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "118501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00248408",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.