Individual provider Active NPI

Christine Myers-Doran, MD

  • Pediatrics Physician
  • Wantagh, NY
National Provider Identifier
1861519316
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
238801 Issued in NY
Practice address
1167 Wantagh Ave
Wantagh, NY 11793-2136
Phone
(516) 900-1201
Fax
(516) 900-1202
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 238801 NY
Pediatrics Physician 208000000X 238801 NY Primary

Addresses

Primary practice location

1167 Wantagh Ave
Wantagh, NY 11793-2136

Mailing address

21 Summit Ave
Lynbrook, NY 11563-2021
Phone (516) 612-3358

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
I20090721000582 NY Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 8527110618 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Mar 6, 2019 Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 6, 2019 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Apr 13, 2015 Accepting new patients

Locations

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

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

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1167 Wantagh Ave
Wantagh, NY 11793
Phone (516) 900-1201

Networks

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1861519316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SUMMIT AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632021",
            "telephone_number": "516-612-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932136",
            "telephone_number": "516-900-1201",
            "fax_number": "516-900-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS-DORAN",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "238801",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "238801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.