PETER EVAN PROTZEL DDS, MD
NPI 1700802980
Oral & Maxillofacial Surgery in Bethpage, NY

NPI Status: Active since July 14, 2006

Contact Information

4277 HEMPSTEAD TPKE
SUITE 214
BETHPAGE, NY
ZIP 11714
Phone: (516) 735-6505
Fax: (516) 735-3326

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  • Individual
  • Male
  • Years of Experience 27
  • Oral & Maxillofacial Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PETER PROTZEL

This page provides the complete NPI Profile along with additional information for Peter Protzel, a provider established in Bethpage, New York with a medical specialization in Oral & Maxillofacial Surgery and more than 27 years of experience. He graduated from State University Of New York At Stony Brook, School Of Medicine in 1999. The healthcare provider is registered in the NPI registry with number 1700802980 assigned on July 2006. The practitioner's primary taxonomy code is 204E00000X with license number 047168 (NY). The provider is registered as an individual and his NPI record was last updated March 2025.

NPI
1700802980
Provider Name
PETER EVAN PROTZEL DDS, MD
Gender
Male
Entity Type
Individual
Location Address
4277 HEMPSTEAD TPKE SUITE 214 BETHPAGE, NY 11714
Location Phone
(516) 735-6505
Location Fax
(516) 735-3326
Mailing Address
4277 HEMPSTEAD TURNPIKE SUITE 214 BETHPAGE, NY 11714
Mailing Phone
(516) 735-6505
Mailing Fax
(516) 735-3326
Medical School Name
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduation Year
1999
Is Sole Proprietor?
No
Enumeration Date
07-14-2006
Last Update Date
03-12-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Oral & Maxillofacial Surgery

Taxonomy Code
204E00000X
Type
Allopathic & Osteopathic Physicians
License No.
047168
License State
NY
Taxonomy Description
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223S0112XDental Providers

Dentist
Oral and Maxillofacial Surgery

047168 (NY)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 9200 (+ Incentives) - HMO
  • Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 9200 (+ Incentives) - EPO
  • Anthem Bronze Pathway HMO 7450 for HSA - HMO
  • Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
  • Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • BEST Life Superior Dental Plan - PPO
  • BEST Essential Basic Dental Plan - PPO
  • BEST Life Essentail Basic Dental Plan - PPO
  • BEST Life Essentail Value Dental Plan - PPO
  • BEST Life Essental Value Dental Plan - PPO
  • BEST Life Essential Basic Dental - PPO
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Basic Dental - PPO
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Vakue Dental Plan - PPO
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Essential Value Dental - PPO
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Preferred Dental - PPO
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Preferred Dental plan - PPO
  • BEST Life Superior Dental - PPO
  • BEST Life Superior Dental Plan - PPO
  • BEST Life Superior Dental Plan - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueDental Copayment Q - PPO
  • BlueDental Copayment QF - PPO
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Humana Dental Smart Choice Basic - PPO
  • Humana Dental Smart Choice- Lite - PPO
  • Paramount Dental Essential Plus Plan - EPO
  • Paramount Dental Preventive Family Plan - EPO
  • Paramount Dental Total Care Plan - EPO
  • HRI Essential Plus Plan - HMO
  • HRI Essential Plus Plan - PPO
  • HRI Preventive Family Plan - HMO
  • HRI Preventive Family Plan - PPO
  • HRI Total Care Plan - HMO
  • HRI Total Care Plan - PPO
  • Alabama Preferred Plan - PPO
  • Alabama Preferred Plan (Pediatric Only) - PPO
  • Alabama Preferred Plus Plan - PPO
  • Alabama Preferred Plus Plan (Pediatric Only) - PPO
  • Alabama Wellness Essentials Plan - PPO
  • Florida Preferred Plan - PPO
  • Florida Preferred Plan (Pediatric Only) - PPO
  • Florida Preferred Plus Plan - PPO
  • Florida Preferred Plus Plan (Pediatric Only) - PPO
  • Florida Wellness Essentials Plan - PPO
  • High PPO Dental Plan - PPO
  • High PPO Dental Plan (Pediatric Only) - PPO
  • Kansas Preferred Plan - PPO
  • Kansas Preferred Plan (Pediatric Only) - PPO
  • Kansas Wellness Essentials Plan - PPO
  • Low PPO Dental Plan - PPO
  • Low PPO Dental Plan (Pediatric Only) - PPO
  • Mississippi Preferred Plan - PPO
  • Mississippi Preferred Plan (Pediatric Only) - PPO
  • Mississippi Wellness Essentials Plan - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Illinois - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Tennessee - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
02339499MEDICAID (05)NY 

Medicare Participation & PECOS Enrollment Status

Peter Protzel is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Peter Protzel is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 749244630

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20041122000419

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 15 times for 13 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 27 times for 27 patients

X-ray of lower jaws, upper jaws and teeth

An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.

This service was performed 12 times for 12 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Peter Protzel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LONG ISLAND JEWISH MEDICAL CENTER270 - 05 76TH AVENUE
NEW HYDE PARK, NY 11040
(718) 470-7000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1700802980
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27001604916
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 0 + 0 + 1 + 6 + 0 + 4 + 9 + 1 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1700802980 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083602320DR. JOHN R THANUS MD
Individual
Obstetrics & Gynecology4277 HEMPSTEAD TPKE SUITE 102
BETHPAGE, NY 11714
(516) 731-5100
1255317236DR. ANNETTE A COHEN MD
Individual
Dermatology (Dermatopathology)4277 HEMPSTEAD TPKE SUITE 206
BETHPAGE, NY 11714
(516) 731-6505
1407883176DR. MARK WEINSTEIN M.D.
Individual
Internal Medicine4277 HEMPSTEAD TPKE SUITE 209
BETHPAGE, NY 11714
(516) 731-7770
1063431922DR. ALAN P SITRON M.D.
Individual
Nuclear Medicine4277 HEMPSTEAD TPKE SUITE 200
BETHPAGE, NY 11714
(516) 796-4340
1538177282DR. ELISA KADISH M.D.
Individual
Nuclear Medicine4277 HEMPSTEAD TPKE SUITE 200
BETHPAGE, NY 11714
(516) 796-4340
1285748749ISLAND MEDICAL GROUP, PC
Organization
Internal Medicine4277 HEMPSTEAD TPKE SUITE 209
BETHPAGE, NY 11714
(516) 731-7770
1154438695 JORDAN MARC GARELICK MD
Individual
Ophthalmology4277 HEMPSTEAD TPKE 109
BETHPAGE, NY 11714
(516) 796-4030
1366559809 LAURENCE RUBIN MD
Individual
Ophthalmology4277 HEMPSTEAD TPKE 109
BETHPAGE, NY 11714
(516) 796-4030
1275640716 GREGORY COWAN MD
Individual
Ophthalmology4277 HEMPSTEAD TPKE 109
BETHPAGE, NY 11714
(516) 796-4030
1063529501 TED ALLAN KARL MD
Individual
Ophthalmology4277 HEMPSTEAD TPKE #109
BETHPAGE, NY 11714
(516) 796-4030
1881701324 LISA DOREEN PAOLINI MD
Individual
Ophthalmology4277 HEMPSTEAD TPKE #109
BETHPAGE, NY 11714
(516) 796-4030
1831209568DR. MARK STEVEN ROTHMAN DDS
Individual
Dentist (General Practice)4277 HEMPSTEAD TPKE SUITE 104
BETHPAGE, NY 11714
(516) 735-2324
1790884344 PETER BUFFA M.D.
Individual
Internal Medicine4277 HEMPSTEAD TPKE SUITE 209
BETHPAGE, NY 11714
(516) 731-7770
1366536542DR. PAUL DANTES M.D.
Individual
Radiology (Body Imaging)4277 HEMPSTEAD TPKE SUITE 200
BETHPAGE, NY 11714
(516) 796-4340
1518047901 JOSEPH GARBARINO CDE
Individual
Dietitian, Registered4277 HEMPSTEAD TPKE
BETHPAGE, NY 11714
(516) 731-7770
1225104979BETHPAGE MAGNETIC RESONANCE IMAGING, PC
Organization
Radiology (Diagnostic Radiology)4277 HEMPSTEAD TPKE
BETHPAGE, NY 11714
(516) 579-8500
1861559114DR. SIMON EDELSTEIN M.D.
Individual
Nuclear Medicine4277 HEMPSTEAD TPKE SUITE 200
BETHPAGE, NY 11714
(516) 796-4340
1366638397PROTZEL ORAL & MAXILLOFACIAL SURGERY, LLP
Organization
Dentist (Oral and Maxillofacial Surgery)4277 HEMPSTEAD TPKE SUITE 214
BETHPAGE, NY 11714
(516) 735-6505
1881851459 MAKSIM LAKHTER PHARM D
Individual
Pharmacist4277 HEMPSTEAD TPKE
BETHPAGE, NY 11714
(516) 796-4004
1972731719 AMY P MORSE P.T., LMT,LAC
Individual
Physical Medicine & Rehabilitation4277 HEMPSTEAD TPKE SUITE 102
BETHPAGE, NY 11714
(516) 731-5100

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700802980, enumerated in the NPI registry as an "individual" on July 14, 2006

The provider is located at 4277 Hempstead Tpke Suite 214 Bethpage, Ny 11714 and the phone number is (516) 735-6505

The provider's speciality is Oral & Maxillofacial Surgery with taxonomy code 204E00000X

The provider has more than 27 years of experience. He graduated from State University Of New York At Stony Brook, School Of Medicine in 1999.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Antidote Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 30-39 minutes, New patient office or other outpatient visit, 45-59 minutes and X-ray of lower jaws, upper jaws and teeth.

The practitioner is affiliated to the following hospital(s): LONG ISLAND JEWISH MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.