Individual provider Active NPI

Justin Lobello, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Northport, NY
National Provider Identifier
1912376435
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P99425 Issued in NY
Practice address
79 Middleville Rd
Building 7, Room 106C
Northport, NY 11768-2200
Phone
(631) 261-4400
NPI assigned
Sep 15, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X P99425 NY Primary

Addresses

Primary practice location

79 Middleville Rd
Building 7, Room 106C
Northport, NY 11768-2200

Mailing address

22 Udell Way
East Northport, NY 11731-3714

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912002991 NY Practitioner - Podiatry 5991055964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massapequa Podiatry Associates PCGroup PAC ID 2769593946, 2 clinicians

Practice addresses (Care Compare)

4160 Merrick Rd
Massapequa, NY 11758-6000
Phone (516) 541-9000

Hospital & facility affiliations

  • Plainview Hospital Hospital, Plainview, NY, CCN 330331

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue17
Removal of skin lesions33
Removal of nail tissue1036
Removal or shaving of skin growth738
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P99425NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Massapequa Podiatry Associates, P.C. Foot & Ankle Surgery CurrentSince Aug 1, 2018 Accepting new patients

Locations

4160 Merrick Rd
Ste 1
Massapequa, NY 11758
Phone (516) 541-9000

4160 Merrick Rd
Massapequa, NY 11758
Phone (516) 541-9000

Organizations & group practices 1

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": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1912376435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 UDELL WAY",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "address_2": "BUILDING 7, ROOM 106C",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBELLO",
        "first_name": "JUSTIN",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "P99425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.