EDWARD M CONDON MD
NPI 1225058969
Internal Medicine - Endocrinology, Diabetes & Metabolism in Commack, NY

Active since July 19, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 33D1087089 · Certificate of Compliance
79.98/100
CMS Quality Rating
6080 JERICHO TPKE, SUITE 314, COMMACK, NY 11725(631) 462-2200(866) 852-5985 Get Directions Write a Review

NPPES record last updated: July 31, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edward M Condon Md NPPES

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

EDWARD M CONDON MD (NPI 1225058969) is an individual endocrinology, diabetes & metabolism provider in Commack, New York, licensed in New York (127245) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, holds a CLIA Certificate of Compliance certificate valid through September 13, 2027, and is affiliated with Suny/stony Brook University Hospital.

NPPES Registry Identity

NPI1225058969
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameEDWARD M CONDONCredential: MD
Location Address6080 JERICHO TPKE, SUITE 314Commack, NY 11725-2850
Mailing Address6080 Jericho Tpke, Suite 314Commack, NY 11725-2850 · (631) 462-2200 · Fax (866) 852-5985
Fax(866) 852-5985
Sole ProprietorYes
Medical School CMSOtherGraduated 1973
Enumeration DateJuly 19, 2006
Last NPPES UpdateJuly 31, 2012
NPI 1225058969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License Licensed in NY · 127245
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
6080 JERICHO TPKE, Commack, NY 11725

Other Identifiers 12

Other230035NY · Ghi Ppo
Medicare UPINB13670NY
Medicare PINP00205730GA
Medicare PIN354781NY
Other2190581NY · Cigna
Other3C6337NY · Health Net
Medicaid02215447NY
OtherEC094S0510NY · Empire Bcbs-ny
Other000000080165NY · Ghi Hmo
OtherP3194859NY · Oxford Health Plan
Other3444104NY · Aetna/us Healthcare Hmo
Other4312729NY · Aetna/us Healthcare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Edward M Condon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284601998
PECOS Enrollment IDI20040913000959
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D1087089

Edward Condon Medical PC · Commack, NY
Active · expires Sep 13, 2027
CLIA Number33D1087089
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorDr. Maria E. Pena
Laboratory Phone(631) 462-2200
Laboratory LocationEdward Condon Medical PC6080 Jericho Turnpike, Suite 314, Commack, NY 11725
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Areas of Expertise CMS Part B claims 53

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
2,957 services1,073 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
2,004 services1,000 patients
Blood test, thyroid stimulating hormone (tsh) 84443
A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
1,843 services991 patients
Microsomal antibodies (autoantibody) measurement 86376
Microsomal antibodies measurement is a blood test to detect specific antibodies that your immune system may produce. It's often used to diagnose autoimmune conditions like thyroid disorders. The test is simple, involving a standard blood draw.
1,841 services991 patients
Thyroxine (thyroid chemical), free 84439
The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.
1,839 services990 patients
Thyroid hormone, t3 measurement, free 84481
The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.
1,838 services990 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11725 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.98/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality76.9
Improvement Activities40
Cost57.27

Reported Quality Measures

Controlling High Blood Pressure
74%199 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
2%2,800 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
39%2,800 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
68%22,906 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
37%7,030 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
36%18,141 patients3/55-star benchmark: 61%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
63%2,535 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 1,749 patients
Patients totalRate: 0% · 1,749 patients
0%1,749 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
3 suppliers12 claims156 services$18.35 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
3 suppliers12 claims360 services$2.37 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
3 suppliers16 claims16 services$169.98 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
16 suppliers75 claims304 services$6.84 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
7 suppliers37 claims37 services$2.87 avg. paid by Medicare
Spring-powered device for lancet, each A4258
DME-Other DME · category DE000N
7 suppliers20 claims20 services$1.85 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker
6080 JERICHO TPKE
COMMACK, NY 11725
Nurse Practitioner (Family)
6080 JERICHO TPKE, SUITE 314
COMMACK, NY 11725
Social Worker (Clinical)
6080 JERICHO TPKE, SUITE 304
COMMACK, NY 11725
Behavior Analyst
6080 JERICHO TPKE
COMMACK, NY 11725
Psychiatry & Neurology (Neurology)
6080 JERICHO TPKE
COMMACK, NY 11725
Behavior Technician
6080 JERICHO TPKE
COMMACK, NY 11725
Chiropractor
6080 JERICHO TPKE, SUITE 305
COMMACK, NY 11725
Behavior Technician
6080 JERICHO TPKE
COMMACK, NY 11725

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 Edward Condon's NPI number?

The NPI number for Edward Condon is 1225058969. It was assigned to this individual provider in the NPPES registry on July 19, 2006.

Where is Edward Condon located?

Edward Condon practices at 6080 Jericho Tpke Suite 314, Commack, NY 11725. The listed phone number is (631) 462-2200.

What is Edward Condon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Edward Condon enrolled in Medicare?

Yes. Edward Condon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Edward Condon hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 33D1087089) is associated with this NPI, valid through September 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Edward Condon affiliated with any hospitals?

According to CMS data, Edward Condon is affiliated with Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Edward Condon was last updated on July 31, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.