Long Island Surgical Specialist, P.C.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

LONG ISLAND SURGICAL SPECIALIST, P.C.

Practice address

639 Port Washington Blvd
Port Washington, NY 11050-3733

Phone

(516) 883-2212

Fax

(516) 767-7064

NPI assigned

Jan 27, 2006

Reactivated

Aug 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Renato B Berroya, M.D., F.A.C.S.

Title

Owner

Phone

(516) 883-2212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Zarcone III, MD

  • Surgery Physician
  • Staten Island, NY
  • NPI 1801840509
  Medicare reassignment

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1932170255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 PORT WASHINGTON BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503733",
            "telephone_number": "516-883-2212",
            "fax_number": "516-767-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 PORT WASHINGTON BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503733",
            "telephone_number": "516-883-2212",
            "fax_number": "516-767-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND SURGICAL SPECIALIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2015-09-15",
        "deactivation_date": "2006-05-31",
        "reactivation_date": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "BERROYA",
        "authorized_official_first_name": "RENATO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-883-2212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.C.S."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LNZ Nutrition LLC
• Frank Richard Loffredo, MD
• Jody A Lograsso, M.S.PT
• Long Island Hypertension and Nephrology, PLLC
• Long Island Oral & Maxillofacial Surgery, PC
• Frances R Lopilato, RN
• Christopher Lorentzen, M.S., L.AC.
• Herbert Dennis Lovens, MSW
• LTC Provider Management Corp
• Patricia M Lundy, LCSW PLLC

• Exclusive Provider Organization in Port Washington, NY
• Providers in Port Washington, NY by specialty
• Exclusive Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.