Individual provider Active NPI

Toni-Marie Pernick

  • Nephrology Physician
  • Great Neck, NY
National Provider Identifier
1972122356
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
F308465 Issued in NY
Practice address
891 Northern Blvd
Great Neck, NY 11021-5334
Phone
(516) 775-7555
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X F308465 NY Primary

Addresses

Primary practice location

891 Northern Blvd
Great Neck, NY 11021-5334

Mailing address

2470 Martin Ave
Bellmore, NY 11710-3127
Phone (516) 532-4773

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
I20210901002781 NY Practitioner - Nurse Practitioner 0143626010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Kidney and Hypertension PCGroup PAC ID 3274657374, 2 clinicians

Practice addresses (Care Compare)

891 Northern Blvd
Suite 203
Great Neck, NY 11021-5305
Phone (516) 775-7555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.1 of 100Reported as group
Quality
82.06
Improvement activities
40
Cost
74.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F308465NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Kidney and Hypertension PC Single Specialty CurrentSince Apr 13, 2021 Accepting new patients

Locations

891 Northern Blvd
Ste 203
Great Neck, NY 11021
Phone (516) 773-6300

Organizations & group practices 1

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1972122356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 MARTIN AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103127",
            "telephone_number": "516-532-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 NORTHERN BLVD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215334",
            "telephone_number": "516-775-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNICK",
        "first_name": "TONI-MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "F308465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.