NPIMap

Individual provider Active NPI

David Siskind, MD

  • Geriatric Medicine (Family Medicine) Physician
  • West Islip, NY
National Provider Identifier
1942290994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
187771 Issued in NY
Practice address
111 Beach Dr
West Islip, NY 11795-4929
Phone
(631) 587-1600
NPI assigned
Oct 21, 2005
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
Geriatric Medicine (Family Medicine) Physician 207QG0300X 187771 NY Primary

Addresses

Primary practice location

111 Beach Dr
West Islip, NY 11795-4929

Mailing address

1 Salem CT
Syosset, NY 11791-2914
Phone (516) 521-6556

Other identifiers 1

IdentifierTypeStateIssuer
01766889MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031203000246 NY Practitioner - Family Practice 9931004082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
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
Phone (516) 562-3058

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18771NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jul 27, 2022 Accepting new patients
The Rosalind and Joseph Gurwin Jewish Geriatric Center of Long Island CurrentSince Nov 22, 2011 Accepting new patients
The Rosalind and Joseph Gurwin Jewish Geriatric Center of Long Island CurrentSince Nov 22, 2011 Accepting new patients
Northwell Health Stern Family Center for Rehabilitation Past Accepting new patients
Regional Physician Services, PC PastSince Mar 10, 2009 Accepting new patients

Locations

68 Hauppauge Rd
Commack, NY 11725
Phone (631) 499-6500

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

330 Community Dr
Manhasset, NY 11030
Phone (516) 562-8000

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8825/brand/4/csg/1/fhir/r4
  • Direct secure messaging: dsiskind65445@northwell.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Stern Family Center for Extended Care & RehabilitationManhasset, NY, CCN 335702 Skilled nursing facility W-2 Managing Employee Jan 1, 2000

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942290994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SALEM CT",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117912914",
            "telephone_number": "516-521-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEACH DR",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954929",
            "telephone_number": "631-587-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISKIND",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "187771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01766889",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.