Individual provider Active NPI

Cecily Maliakal Anto, MD

  • Clinical Neurophysiology Physician
  • Hauppauge, NY
National Provider Identifier
1881745602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
145353 Issued in NY
Practice address
521 Route 111
Hauppauge, NY 11788-4370
Phone
(631) 724-4455
Fax
(631) 724-4490
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 145353 NY Primary

Addresses

Primary practice location

521 Route 111
Hauppauge, NY 11788-4370

Mailing address

521 Route 111
Hauppauge, NY 11788-4370
Phone (631) 724-4455

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
I20110927000759 NY Practitioner - Neurology 2668643420 Practice locations: Hauppauge, NY

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

521 Route 111 306
Hauppauge, NY 11788-4358
Phone (631) 724-4455

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401

Merit-based Incentive Payment System (MIPS)

Final score
83.35 of 100Reported as individual
Quality
74.4
Improvement activities
40
Cost
78.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145353NYMDClinical Neurophysiology Physician

Hospital & facility affiliations 4

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881745602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 ROUTE 111",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884370",
            "telephone_number": "631-724-4455",
            "fax_number": "631-724-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ROUTE 111",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884370",
            "telephone_number": "631-724-4455",
            "fax_number": "631-724-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTO",
        "first_name": "CECILY",
        "middle_name": "MALIAKAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "145353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.