Individual provider Active NPI

Simona Vasilica Proteasa, MD

  • Clinical Neurophysiology Physician
  • Great Neck, NY
National Provider Identifier
1831484740
Registry record updated Jun 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
1063 Issued in NY
Practice address
611 Northern Blvd Ste 150
Great Neck, NY 11021-5207
Phone
(516) 325-7000
Fax
(516) 325-7001
NPI assigned
Jun 20, 2011
Last updated
Jun 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 270252 NY
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 12347 NY
Clinical Neurophysiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0600X 1063 NY Primary

Addresses

Primary practice location

611 Northern Blvd Ste 150
Great Neck, NY 11021-5207

Mailing address

611 Northern Blvd Ste 150
Great Neck, NY 11021-5207
Phone (516) 325-7000

Other names 1

  • Ms. Simona Vasilica Heres Former name

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
I20140804000250 NY Practitioner - Neurology 0042437733 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

122 Maple Ave
White Plains, NY 10601-4706
Phone (914) 285-9808

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1063NYMDClinical Neurophysiology Physician
12347NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Single Specialty CurrentSince Sep 9, 2019 Accepting new patients
White Plains Physician Services PC Single Specialty CurrentSince Jan 27, 2026 Accepting new patients
East Post Road Medical Services PC Single Specialty CurrentSince Jan 12, 2026 Accepting new patients
North Shore University Hospital Past Accepting new patients

Locations

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

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

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

611 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 325-7000

300 Community Dr
Manhasset, NY 11030

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

972 Brush Hollow Rd
Westbury, NY 11590

122 Maple Ave
White Plains, NY 10601
Phone (914) 285-9490

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

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

Interoperability endpoints

  • Direct secure messaging: sproteasa67030@northwell.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1831484740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 NORTHERN BLVD STE 150",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215207",
            "telephone_number": "516-325-7000",
            "fax_number": "516-325-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 NORTHERN BLVD STE 150",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215207",
            "telephone_number": "516-325-7000",
            "fax_number": "516-325-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTEASA",
        "first_name": "SIMONA",
        "middle_name": "VASILICA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "270252",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "12347",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "1063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIMONA",
            "last_name": "HERES",
            "middle_name": "VASILICA",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.