Individual provider Active NPI

Luigi M Capobianco, MD

  • Internal Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1902903099
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
174738 Issued in NY
Practice address
1 School St
Glen Cove, NY 11542-2545
Phone
(516) 671-9800
Fax
(516) 671-9283
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 174738 NY Primary

Addresses

Primary practice location

1 School St
Glen Cove, NY 11542-2545

Mailing address

972 Brush Hollow Rd
4TH Floor
Westbury, NY 11590-1740
Phone (516) 876-5555

Other identifiers 1

IdentifierTypeStateIssuer
01463932MedicaidNY

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
I20051006000139 NY Practitioner - Family PracticePractitioner - Geriatric Medicine 0648295980

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Healthcare Internal Medicine Past Accepting new patients
North Shore-Lij Medical PC Internal Medicine Past Accepting new patients
Senior Healthcare Associates, LLC Internal Medicine Past Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1902903099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "address_2": "4TH FLOOR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5555",
            "fax_number": "516-876-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCHOOL ST",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422545",
            "telephone_number": "516-671-9800",
            "fax_number": "516-671-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPOBIANCO",
        "first_name": "LUIGI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "174738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01463932",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.