Myrna K. Nussbaum, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

157104 Issued in NY

Practice address

227 Franklin Ave
Hewlett, NY 11557-1902

Phone

(516) 295-5500

Fax

(516) 569-8225

NPI assigned

Dec 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1972580926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034002",
            "telephone_number": "516-354-4200",
            "fax_number": "516-775-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 FRANKLIN AVE",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571902",
            "telephone_number": "516-295-5500",
            "fax_number": "516-569-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "MYRNA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "157104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01967477",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Shore Long Island Jewish Healthcare Inc.
• North Shore Medical Group of the Mount Sinai School of Medicine
• Robert Samuel Nuba, M.D.
• Antonio Numa Sr.
• Deanna M Nus, OD
• Natalya Ogievetsky, M.D.
• Jeffrey Neal Olin, MD
• Charles Oliver
• Diana Oneill, FNP
• Opt Physical Therapy Rehabilitation PLLC

• Diagnostic Radiology Physician in Hewlett, NY
• Providers in Hewlett, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.