Individual provider Active NPI

Stephen Dolgin, MD

  • Pediatric Surgery Physician
  • New Hyde Park, NY
National Provider Identifier
1942355698
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
158048 Issued in NY
Practice address
Lij Dept of Surgery Pediatric Surgery
269 01 76TH Avenue
New Hyde Park, NY 11040
Phone
(718) 470-3637
NPI assigned
Jan 24, 2007
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
Pediatric Surgery Physician 2086S0120X 158048 NY Primary

Addresses

Primary practice location

Lij Dept of Surgery Pediatric Surgery
269 01 76TH Avenue
New Hyde Park, NY 11040

Mailing address

Lij Dept of Surgery Pediatric Surgery
Lij Dept of Surgery Pediatric Surgery
New Hyde Park, NY 11040
Phone (718) 470-3637

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
I20050808000642 NY Practitioner - General SurgeryPractitioner - Pediatric Medicine 2769411016 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158048NYMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 3, 2012 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 3, 2012 Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

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

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

Interoperability endpoints

  • Direct secure messaging: stephendolgin@nslijmedgr.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942355698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LIJ DEPT OF SURGERY PEDIATRIC SURGERY",
            "address_2": "LIJ DEPT OF SURGERY PEDIATRIC SURGERY",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "718-470-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LIJ DEPT OF SURGERY PEDIATRIC SURGERY",
            "address_2": "269 01 76TH AVENUE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "718-470-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLGIN",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "158048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.