Individual provider Active NPI

Selvin Lloyd Rose

  • Physician Assistant
  • Manhasset, NY
National Provider Identifier
1932877347
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027960 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 562-4970
NPI assigned
Aug 31, 2021
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 027960 NY Primary

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

429 Cedar St
Uniondale, NY 11553-2119
Phone (516) 528-7488

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225001565 NY Practitioner - Physician Assistant 8820482391 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027960NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 1, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

300 Community Dr
Manhasset, NY 11030

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Networks

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1932877347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 CEDAR ST",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115532119",
            "telephone_number": "516-528-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SELVIN",
        "middle_name": "LLOYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.