Sedation Vacation Perioperative Medicine PLLC
Organization Active NPI Specialist · Valley Stream, NY
NPI 1891235404 · NPPES record last updated Apr 18, 2024
Key facts
- NPI
- 1891235404
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 245594 (NY)
- Legal business name
- SEDATION VACATION PERIOPERATIVE MEDICINE PLLC
- Practice address
- 811 Wilson St
Valley Stream, NY 11581-3527 - Phone
- (718) 550-8600
- NPI assigned
- Mar 1, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Avishai T Neuman, M.D.
- Title
- Ceo
- Phone
- (718) 550-8600
Practitioners 313
-
Vyachislav Abayev, M.D.
-
Violeta Rushel Aronov, D.O.
-
Hasan I Berisha, M.D,
-
Heath Blonder, D.O.
-
Sean Seongjou Bok, M.D.
-
Evgeny Bulat, MD, MA
-
Clifford Andrew Charles, CRNA
-
Kelly Yan Chen, MD
-
Leonid Chernyak, DO
-
Shairy Chhabra, M.D.
-
Barry Cohen, M.D.
-
Marc Alan Dany, M.D.
-
Yuriy Davydov, MD
-
Panchali Dhar, MD
-
Geraldine C. Diaz, D.O.
-
Vedan Djesevic, M.D.
-
Larry Evan Franks, M.D.
-
Johnny Garriga, MD
-
Joseph Gaudio, M.D.
-
Dan Geisler, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in NY, CT, PA, NJ, NH, IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170525001955 | NY | Part B Supplier - Clinic/Group Practice | 1759658594 |
Receives reassigned benefits from 297 practitioners Practice locations: Brooklyn, NY; Le Roy, NY; Ozone Park, NY |
| O20220106000094 | CT | Part B Supplier - Clinic/Group Practice | 1759658594 |
Receives reassigned benefits from 1 practitioner Practice locations: Middletown, CT; Norwalk, CT |
| O20220113000035 | PA | Part B Supplier - Clinic/Group Practice | 1759658594 |
Receives reassigned benefits from 13 practitioners Practice locations: Butztown, PA; Holland, PA |
| O20220311000226 | NJ | Part B Supplier - Clinic/Group Practice | 1759658594 |
Receives reassigned benefits from 8 practitioners Practice locations: Belleville, NJ; Orange, NJ |
| O20220422000220 | NH | Part B Supplier - Clinic/Group Practice | 1759658594 |
Receives reassigned benefits from 1 practitioner Practice locations: Salem, NH |
| O20220608000306 | IL | Part B Supplier - Clinic/Group Practice | 1759658594 |
Receives reassigned benefits from 1 practitioner Practice locations: Chicago, IL |
National Provider Directory
Locations
41 W Ida B Wells Dr
Chicago, IL 60605
272 Main St
#B
Orange, NJ 07050
894 Bedford Ave
Brooklyn, NY 11205
1685 Valley Center Pkwy
Unit 200
Butztown, PA 18017
Phone 91768149632278
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 245594 | NY | Yes |
Addresses
Primary practice location
811 Wilson St
Valley Stream, NY 11581-3527
Mailing address
811 Wilson St
Valley Stream, NY 11581-3527
Phone (718) 550-8600
Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.