NPIMap

Organization Active NPI

Custom Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Great Neck, NY
National Provider Identifier
1861567752
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
160215 Issued in NY
Legal business name
CUSTOM ANESTHESIA SERVICES, P.C.
Practice address
65A Beverly Rd
Great Neck, NY 11021-1616
Phone
(917) 822-4074
Fax
(516) 570-2306
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Authorized official

Name
Dr. Ricky Zegelstein, M.D.NPI 1043385933
Title
Owner
Phone
(917) 822-4074

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
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 160215 NY Primary

Addresses

Primary practice location

65A Beverly Rd
Great Neck, NY 11021-1616

Mailing address

65A Beverly Rd
Great Neck, NY 11021-1616
Phone (917) 822-4074

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1861567752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65A BEVERLY RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211616",
            "telephone_number": "917-822-4074",
            "fax_number": "516-570-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65A BEVERLY RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211616",
            "telephone_number": "917-822-4074",
            "fax_number": "516-570-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM ANESTHESIA SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "ZEGELSTEIN",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-822-4074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "160215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.