Individual provider Active NPI

Ahmad Magdy Abdella, DC

  • Chiropractor
  • Middle Island, NY
National Provider Identifier
1962985135
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X013150 Issued in NY
Practice address
285 Middle Country Rd
Middle Island, NY 11953-2505
Phone
(631) 538-0115
NPI assigned
Sep 12, 2018
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X013150 NY Primary

Addresses

Primary practice location

285 Middle Country Rd
Middle Island, NY 11953-2505

Mailing address

1 Wyngate LN
Coram, NY 11727-2218
Phone (347) 756-2559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813000647 NY Practitioner - Chiropractic 8426474016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1787 Middle Country Rd
Centereach, NY 11720-3507

5 Oakridge Cir
Ridge, NY 11961-2319

994 W Jericho Tpke
Suite 104
Smithtown, NY 11787-3211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X013150NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy D. Groth MD PC CurrentSince Jul 21, 2021 Accepting new patients
Abdella Chiropractic, PC Chiropractor CurrentSince Jun 28, 2020 Accepting new patients
Dr. Zaytoun Medical Care PC CurrentSince Nov 27, 2022 Accepting new patients
Freeport Pain Managment PC. Past Accepting new patients
Walter E. Mendoza Chiropractor, P.C PastSince May 27, 2017 Accepting new patients

Locations

1787 Middle Country Rd
Centereach, NY 11720
Phone (631) 320-0447

285 Middle Country Rd
Middle Island, NY 11953
Phone (631) 538-0115

1500 William Floyd Pkwy
Ste 201
Shirley, NY 11967
Phone (631) 205-0800

994 W Jericho Tpke
Ste 104
Smithtown, NY 11787
Phone (516) 400-3595

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1962985135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYNGATE LN",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272218",
            "telephone_number": "347-756-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532505",
            "telephone_number": "631-538-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELLA",
        "first_name": "AHMAD",
        "middle_name": "MAGDY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X013150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.