Jack M. Levine, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

145681 Issued in NY

Practice address

6940 Main St
Kew Gardens Hills, NY 11367-1723

Phone

(718) 268-5282

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

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

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.

• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1902822992
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1003832098
  NPD
• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1730530940
  NPD
• Goldstein & Levine PTR

  • Pediatrics Physician
  • Kew Gardens Hills, NY
  • NPI 1598891061
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1962588301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ASPEN PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212810",
            "telephone_number": "516-466-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 MAIN ST",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113671723",
            "telephone_number": "718-268-5282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14149 70th Rd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113671936",
            "country_code": "US",
            "telephone_number": "718-268-5282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JACK",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "145681",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "145681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00801390",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lingsum Hsucheng, PT, DPT
• Stephen Jue
• Brianna Simone Kelly, MS
• Rochelle Khanimov
• LCSW Interventions for Emotional Growth, PC
• Emily Lorber
• Asha Mampilly, OTR/L
• Molly T McMahon, MSED
• Rachel Lynn Mendoza, OTR
• Victoria K Mirosh

• Pediatrics Physician in Kew Gardens Hills, NY
• Providers in Kew Gardens Hills, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.