Individual provider Active NPI

Kenneth Angelo Saad, D.O.

  • Anesthesiology Physician
  • Bay Shore, NY
National Provider Identifier
1932557014
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
302799 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(631) 903-1592
NPI assigned
May 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 302799 NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

511A W Broadway
Long Beach, NY 11561-3045
Phone (631) 903-1592

Other practice location 1

1500 Lansdowne Ave # 19023
Darby, PA 19023-1200
Phone (610) 237-4000

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
I20200606000044 NY Practitioner - Anesthesiology 3375831175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (516) 674-7300

195 E Main St
Huntington, NY 11743-2957
Phone (914) 666-8866

301 E Main St
Bay Shore, NY 11706-8408
Phone (914) 666-8866

Hospital & facility affiliations

  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302799NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endoscopy Center of Long Island LLC CurrentSince Apr 1, 2022 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Mar 1, 2020 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

711 Stewart Ave
Ste 114
Garden City, NY 11530
Phone (516) 227-3254

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

Networks

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

Organizations & group practices 2

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 2

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": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1932557014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511A W BROADWAY",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613045",
            "telephone_number": "631-903-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-903-1592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Lansdowne Ave # 19023",
            "address_purpose": "LOCATION",
            "city": "Darby",
            "state": "PA",
            "postal_code": "190231200",
            "country_code": "US",
            "telephone_number": "610-237-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAAD",
        "first_name": "KENNETH",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-30",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "302799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.