Individual provider Active NPI

Surya Vishnubhakat, MD

  • Neurology Physician
  • Manhasset, NY
National Provider Identifier
1912052663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
125347 Issued in NY
Practice address
Nsuh Dept of Neurology
300 Community Drive
Manhasset, NY 11030
Phone
(516) 562-4302
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

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
Neurology Physician 2084N0400X 125347 NY Primary

Addresses

Primary practice location

Nsuh Dept of Neurology
300 Community Drive
Manhasset, NY 11030

Mailing address

Nsuh Dept of Neurology
300 Community Drive
Manhasset, NY 11030
Phone (516) 562-4302

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
I20080116000478 NY Practitioner - Neurology 1052492410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

611 Northern Blvd
Suite 200
Great Neck, NY 11021-5201
Phone (516) 723-2663

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

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
125347NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
North Shore Long Island Jewish Health Care Inc CurrentSince Feb 21, 2007 Accepting new patients
North Shore Long Island Jewish Healthcare CurrentSince Feb 21, 2007 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

100 Community Dr
Great Neck, NY 11021
Phone (516) 365-1805

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

611 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 325-7000

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: suryavishnubhakat@nslijmedgr.allscriptsdirect.net

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.

Hospital & facility affiliations 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912052663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NSUH DEPT OF NEUROLOGY",
            "address_2": "300 COMMUNITY DRIVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-562-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NSUH DEPT OF NEUROLOGY",
            "address_2": "300 COMMUNITY DRIVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-562-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISHNUBHAKAT",
        "first_name": "SURYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "125347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.