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ADVANCED PLASTIC SURGERY OF NORTHSHORE, P.C.
NPI 1114114105
Specialist in Lake Success, NY

Active since October 03, 2007
2500 MARCUS AVENUE, SUITE, 103, LAKE SUCCESS, NY 11042(516) 354-1330(516) 775-5953 Get Directions Write a Review

NPPES record last updated: September 19, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 19, 2022, Sep 15, 2022 (2 updates tracked since 2022).

About Advanced Plastic Surgery Of Northshore, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED PLASTIC SURGERY OF NORTHSHORE, P.C. (NPI 1114114105) is a healthcare organization registered as a specialist in Lake Success, New York and active in the NPI registry since October 2007. The organization lists Mahira Tanovic, Plastic And Hand Surgeon, as its authorized official.

NPPES Registry Identity

NPI1114114105
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameADVANCED PLASTIC SURGERY OF NORTHSHORE, P.C.
Location Address2500 MARCUS AVENUE, SUITE, 103Lake Success, NY 11042-1018
Mailing Address2500 Marcus Avenue, Suite, 103Lake Success, NY 11042-1018 · (516) 354-1330 · Fax (516) 775-5953
Phone(516) 354-1330
Fax(516) 775-5953
Organization SubpartNo
Authorized OfficialMahira TanovicPlastic And Hand Surgeon · (516) 354-1330
Enumeration DateOctober 3, 2007
Last NPPES UpdateSeptember 19, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2022
✔ NPI 1114114105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2500 MARCUS AVENUE, Lake Success, NY 11042
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Plastic Surgery Of Northshore, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Advanced Plastic Surgery Of Northshore, P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Mahira Tanovic, MD
Plastic and Reconstructive Surgery
NPI 1942389317
2500 MARCUS AVENUE SUITE, 103
Lake Success, NY 11042
(516) 354-1330
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advanced Plastic Surgery Of Northshore, P.C.'s NPI number?

The NPI number for Advanced Plastic Surgery Of Northshore, P.C. is 1114114105. It was assigned to this organization in the NPPES registry on October 3, 2007.

Where is Advanced Plastic Surgery Of Northshore, P.C. located?

Advanced Plastic Surgery Of Northshore, P.C. is located at 2500 Marcus Avenue Suite, 103, Lake Success, NY 11042. The listed phone number is (516) 354-1330.

What is Advanced Plastic Surgery Of Northshore, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Advanced Plastic Surgery Of Northshore, P.C. enrolled in Medicare?

Yes. Advanced Plastic Surgery Of Northshore, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Plastic Surgery Of Northshore, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Advanced Plastic Surgery Of Northshore, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Advanced Plastic Surgery Of Northshore, P.C. was last updated on September 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.