Lee Merrick Shangold, M.D.

Primary specialty

Sleep Medicine (Otolaryngology) PhysicianTaxonomy code 207YS0012X

License

172268 Issued in NY

Practice address

1500 Route 112
BLDG. 4 - 2ND Floor
Port Jefferson Station, NY 11776-8054

Phone

(631) 828-7001

Fax

(631) 928-0185

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Otolaryngology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Merit-based Incentive Payment System (MIPS)

Final score

94.45 of 100Reported as group

Quality

89.91

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: lee.shangold@direct.entandallergy.nextgenshare.com

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.

• ENT and Allergy Associates LLP

  • Otolaryngology Physician
  • Tarrytown, NY
  • NPI 1376598326

  NJ

  Medicare reassignment Care Compare group NPD
• Otolaryngology Associates of Long Island

  • Specialist
  • Port Jefferson, NY
  • NPI 1710074935
  NPD (past)
• ENT and Allergy Associates of Pennsylvania PLLC

  • Allergy & Immunology Physician
  • Horsham, PA
  • NPI 1548098759

  Otolaryngology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation
• St Charles Hospital Corp

  dba St. Charles Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1902887730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-984-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112",
            "address_2": "BLDG. 4 - 2ND FLOOR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768054",
            "telephone_number": "631-828-7001",
            "fax_number": "631-928-0185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Patchogue Yaphank Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724894",
            "country_code": "US",
            "telephone_number": "631-654-0550",
            "fax_number": "631-654-0129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANGOLD",
        "first_name": "LEE",
        "middle_name": "MERRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "172268-1",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "NY",
            "license": "172268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1502405",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P01210116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Robert Sergiacomi, L.M.S.W.
• Ronika Sethi, DPM
• Maria T Sgroi, SLP
• Orli Shalouh I
• Susan B Shanahan, RN
• Mark A Shapiro, MD
• Perry Shapiro
• Jessica B. Sharaby-Monaco
• Wajiha Sheikh, PT
• Nicole Janelle Shellard, OTR/L

• Otolaryngology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.