MOUNT SINAI DOCTORS SOUTH NASSAU
NPI 1417449976
Internal Medicine - Cardiovascular Disease in Oceanside, NY

Q: What is Icahn School Of Medicine At Mount Sinai's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Active since May 31, 2018CLIA Certified · 2 labs

1 HEALTHY WAY, OCEANSIDE, NY 11572(516) 255-1618 Get Directions Write a Review

NPPES record last updated: May 31, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mount Sinai Doctors South Nassau NPPES

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

MOUNT SINAI DOCTORS SOUTH NASSAU (NPI 1417449976) is a healthcare organization registered as a cardiovascular disease in Oceanside, New York and active in the NPI registry since May 2018. The organization holds 2 active CLIA laboratory certificates, maintains 14 additional practice locations, and lists Alicia Gresham, Vp Of Network Operations, as its authorized official.

NPPES Registry Identity

NPI1417449976

Entity TypeOrganization

Primary Taxonomy207RC0000X

Legal Business NameICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Location Address1 HEALTHY WAYOceanside, NY 11572

Mailing Address1 Healthy WayOceanside, NY 11572-1551 · (516) 255-1618

Phone(516) 255-1618

Organization SubpartNo

Authorized OfficialAlicia GreshamVp Of Network Operations · (212) 659-9038

Enumeration DateMay 31, 2018

✔ NPI 1417449976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedObstetrics & Gynecology · Maternal & Fetal MedicineTaxonomy 207VM0101X

Also ListedPathology · Clinical PathologyTaxonomy 207ZC0006X

Also ListedPediatrics · Neonatal-Perinatal MedicineTaxonomy 2080N0001X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPsychiatry & Neurology · Behavioral Neurology & NeuropsychiatryTaxonomy 2084B0040X

Also ListedRadiology · Radiation OncologyTaxonomy 2085R0001X

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X

Also ListedSurgeryTaxonomy 208600000X

Also ListedHospitalistTaxonomy 208M00000X

1 HEALTHY WAY, Oceanside, NY 11572

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Other Names 1

Doing Business AsMount Sinai Doctors South Nassau

Secondary Practice Locations 14

Location 1250 Fulton Ave Fl 1Hempstead, NY 11550-3917 · Phone (516) 255-8400

Location 22280 Grand Ave Ste 208Baldwin, NY 11510-3110 · Phone (516) 623-4800

Location 32277 Grand AveBaldwin, NY 11510-3148 · Phone (516) 623-4800

Location 42209 Merrick Rd Ste 101Merrick, NY 11566-4770 · Phone (516) 546-5000

Location 5215 Rockaway TpkeLawrence, NY 11559-1216 · Phone (516) 374-5024

Location 6196 Merrick RdOceanside, NY 11572-1420 · Phone (516) 255-8400

Location 7185 Merrick RdOceanside, NY 11572-1431 · Phone (516) 766-6550

Location 8175 Fulton Ave Ste 309Hempstead, NY 11550-3702 · Phone (516) 546-1370

Location 9155 W Merrick RdFreeport, NY 11520-3743 · Phone (516) 379-3139

Location 101436 BroadwayHewlett, NY 11557-1405 · Phone (516) 497-7422

Location 111420 BroadwayHewlett, NY 11557-1321 · Phone (516) 374-8631

Location 12123 Grove Ave Ste 216Cedarhurst, NY 11516-2302 · Phone (516) 569-5200

Location 131200 W Broadway Unit 5Hewlett, NY 11557-1913 · Phone (516) 887-7000

Location 1410 E Merrick Rd Ste 207Valley Stream, NY 11580-5800 · Phone (516) 256-2017

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 33D2071015

Icahn School Of Medicine At Mount Sinai Dba Hewlett Medical Group · Hewlett, NY

Active · expires Mar 26, 2027

CLIA Number33D2071015

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateDecember 31, 2013

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Kathleen A. Leonard

Laboratory Phone(929) 210-6550

Laboratory LocationIcahn School Of Medicine At Mount Sinai Dba Hewlett Medical Group1436 Broadway, Hewlett, NY 11557

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 33D1003790

Mount Sinai South Nassau PC · Oceanside, NY

Active · expires Mar 26, 2027

CLIA Number33D1003790

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateOctober 10, 2012

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Samuel A. Sandowski

Laboratory Phone(516) 255-8400

Laboratory LocationMount Sinai South Nassau PC196 Merrick Road, Oceanside, NY 11572

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

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.

DR. BENJAMIN WALLBRUNN FELDER DO

Internal Medicine