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MEDICAL SERVICES OF KIPS BAY PC
NPI 1669075651
Psychiatry & Neurology - Neurology in Great Neck, NY

Active since November 20, 2020
170 GREAT NECK RD, GREAT NECK, NY 11021(516) 487-4464(516) 487-4980 Get Directions Write a Review

NPPES record last updated: October 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 6, 2022, Nov 11, 2021, Nov 20, 2020 (3 updates tracked since 2020).

About Medical Services Of Kips Bay Pc NPPES

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

MEDICAL SERVICES OF KIPS BAY PC (NPI 1669075651) is a healthcare organization registered as a neurology in Great Neck, New York and active in the NPI registry since November 2020. The organization lists Michele L Cusack, Senior Vice President & Cfo, as its authorized official.

NPPES Registry Identity

NPI1669075651
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameMEDICAL SERVICES OF KIPS BAY PC
Location Address170 GREAT NECK RDGreat Neck, NY 11021-3357
Mailing Address325 E Main StPatchogue, NY 11772-3114 · (516) 358-8100 · Fax (631) 654-1474
Phone(516) 487-4464
Fax(516) 487-4980
Organization SubpartNo
Authorized OfficialMichele L CusackSenior Vice President & Cfo · (516) 321-6058
Enumeration DateNovember 20, 2020
Last NPPES UpdateOctober 6, 20223 updates tracked since enumeration
NPPES CertifiedOctober 6, 2022
✔ NPI 1669075651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedInternal Medicine · Addiction MedicineTaxonomy 207RA0401X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedPhysician AssistantTaxonomy 363A00000X
170 GREAT NECK RD, Great Neck, NY 11021
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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE 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)

Medical Services Of Kips Bay Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

32

Medicare enrollment records show 32 clinicians reassign Medicare billing to Medical Services Of Kips Bay PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Diagnostic Radiology23
Neurology4
Nurse Practitioner3
Clinical Psychologist1
Interventional Pain Management1

Nearest to this location (20)

See all 32
Peiyun Chu, MD
Neurology
NPI 1467520536
170 GREAT NECK RD
Great Neck, NY 11021
(516) 487-4464
✔ PECOS✔ Accepts MedicareSame address
Adham Kamel Elokda, MD
Neurology
NPI 1225264526
170 GREAT NECK RD
Great Neck, NY 11021
(516) 487-2020
✔ PECOS✔ Accepts MedicareSame address
Reena Varghese
Nurse Practitioner
NPI 1144929829
170 GREAT NECK RD
Great Neck, NY 11021
(516) 487-4464
✔ PECOS✔ Accepts MedicareSame address
Itzhak Haimovic, M.D.
Neurology
NPI 1629075767
170 GREAT NECK ROAD
Great Neck, NY 11021
(516) 487-4464
✔ PECOS✔ Accepts MedicareSame address
Russell Surasky, D.O.
Neurology
NPI 1538484647
15 BARSTOW ROAD
Great Neck, NY 11020
(516) 458-3798
✔ PECOS✔ Accepts Medicare0.5 mi
Ralph Milillo, M.D.
Diagnostic Radiology
NPI 1730353491
611 NORTHERN BLVD STE 250
Great Neck, NY 11021
(516) 325-7203
✔ PECOS✔ Accepts Medicare0.8 mi
Michael Brown
Diagnostic Radiology
NPI 1316261118
300 COMMUNITY DR DEPARTMENT OF RADIOLOGY
Manhasset, NY 11030
(212) 562-3560
✔ PECOS✔ Accepts Medicare1.6 mi
Helise Coopersmith, MD
Diagnostic Radiology
NPI 1285757518
300 COMMUNITY DR
Manhasset, NY 11030
(516) 562-3560
✔ PECOS✔ Accepts Medicare1.6 mi
Eric Goodman, M.D.
Diagnostic Radiology
NPI 1861705253
300 COMMUNITY DR DEPARTMENT OF RADIOLOGY
Manhasset, NY 11030
(516) 562-4800
✔ PECOS✔ Accepts Medicare1.6 mi
John O Donnell, MD
Diagnostic Radiology
NPI 1073806824
300 COMMUNITY DR DEPARTMENT OF RADIOLOGY
Manhasset, NY 11030
(516) 562-4797
✔ PECOS✔ Accepts Medicare1.6 mi
Gregory Timm, M.D.
Diagnostic Radiology
NPI 1861450611
300 COMMUNITY DR
Manhasset, NY 11030
(165) 624-8005
✔ PECOS✔ Accepts Medicare1.6 mi
Daniel Walz, M.D.
Diagnostic Radiology
NPI 1679792998
300 COMMUNITY DR DEPT. OF RADIOLOGY
Manhasset, NY 11030
(516) 562-4084
✔ PECOS✔ Accepts Medicare1.6 mi
Karen Black
Diagnostic Radiology
NPI 1467582858
300 COMMUNITY DRIVE NSUH-DEPT. OF RADIOLOGY
Manhasset, NY 11030
(516) 562-4800
✔ PECOS✔ Accepts Medicare1.6 mi
Richard Siegmann, MD
Diagnostic Radiology
NPI 1619989472
600 COMMUNITY DR SUITE 304
Manhasset, NY 11030
(516) 823-8010
✔ PECOS✔ Accepts Medicare1.7 mi
Pamela Walsh, M.D.
Diagnostic Radiology
NPI 1831457829
270-05 76TH AVENUE LONG ISLAND JEWISH MEDICAL CENTER DEPT OF RADIOLOGY
New Hyde Park, NY 11040
(718) 470-4585
✔ PECOS✔ Accepts Medicare2.4 mi
Mobeen Farooq
Diagnostic Radiology
NPI 1932631447
27005 76TH AVE
New Hyde Park, NY 11040
(718) 470-4475
✔ PECOS✔ Accepts Medicare2.7 mi
Craig Warshall, MD
Diagnostic Radiology
NPI 1770680365
27005 76TH AVE
New Hyde Park, NY 11040
(718) 470-7175
✔ PECOS✔ Accepts Medicare2.7 mi
Joshua Hofman
Diagnostic Radiology
NPI 1467578203
LIJMC - DEPT. OF RADIOLOGY 270-05 76TH AVENUE
New Hyde Park, NY 11040
(718) 470-7175
✔ PECOS✔ Accepts Medicare2.8 mi
Daniella Yakubov
Nurse Practitioner
NPI 1023715570
7502 186TH ST
Fresh Meadows, NY 11366
(718) 223-0300
✔ PECOS4.6 mi
Grace Forde, M.D.
Interventional Pain Management
NPI 1508861816
900 FRANKLIN AVE
Valley Stream, NY 11580
(516) 256-6000
✔ PECOS✔ Accepts Medicare7.4 mi
See all 32 clinicians

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 Medical Services Of Kips Bay PC's NPI number?

The NPI number for Medical Services Of Kips Bay PC is 1669075651. It was assigned to this organization in the NPPES registry on November 20, 2020.

Where is Medical Services Of Kips Bay PC located?

Medical Services Of Kips Bay PC is located at 170 Great Neck Rd, Great Neck, NY 11021. The listed phone number is (516) 487-4464.

What is Medical Services Of Kips Bay PC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Medical Services Of Kips Bay PC enrolled in Medicare?

Yes. Medical Services Of Kips Bay PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Medical Services Of Kips Bay PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 32 clinicians in 5 Medicare specialties reassign their Medicare billing to Medical Services Of Kips Bay PC. 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. The largest specialties are Diagnostic Radiology (23), Neurology (4) and Nurse Practitioner (3). Of these, 4 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Medical Services Of Kips Bay PC was last updated on October 6, 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.