LEE MERRICK SHANGOLD (NPI# 1902887730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902887730 |
| Entity Type | Individual |
| Full Name | LEE MERRICK SHANGOLD |
| Credential | M.D. |
| Practice Address |
1500 Route 112 Bldg. 4 - 2nd Floor Port Jefferson Station NY 11776-8054 |
| Mailing Address |
660 White Plains Rd Fl 4 Tarrytown NY 10591-5139 |
| Practice Telephone | 6318287001 |
| Practice Fax Number | 6319280185 |
| Mailing Telephone | 9149842546 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 172268-1 | NY | Allopathic & Osteopathic Physicians |
| Y | 207YS0012X |
Otolaryngology Specialization: Sleep Medicine |
172268 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 1502405 | 05 | |
| NY | RAILROAD MEDICARE PIN | P01210116 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 240 Patchogue Yaphank Rd Ste 1, East Patchogue, NY 117724894 | 6316540550 | 6316540129 |
| Street Address |
1500 ROUTE 112 BLDG. 4 - 2ND FLOOR |
| City | PORT JEFFERSON STATION |
| State | NY |
| Zip Code | 11776-8054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366446726 | Jeffrey L Vacirca | Internal Medicine | 1500 Route 112, Bldg 4, Port Jefferson Station, NY 11776-8055 | 2005-06-13 |
| 1740807791 | Sarah Lynn Frisina | Audiologist | 1500 Route 112, Building 4 Second Fl, Port Jefferson Station, NY 11776 | 2020-06-25 |
| 1982262903 | North Shore-lij Cardiovascular Medicine PC | Orthopaedic Surgery | 1500 Route 112, Port Jefferson Station, NY 11776-8054 | 2019-06-04 |
| 1881134815 | Port Jefferson Asc, LLC | Clinic/Center | 1500 Route 112, Bldg 3, Port Jefferson Station, NY 11776 | 2017-02-23 |
| 1538533344 | Jacqueline Schomber | Psychologist | 1500 Route 112, Bldg 6, Port Jefferson Station, NY 11776-8054 | 2015-11-17 |
| 1235551052 | Long Island Digestive Endoscopy Center, LLC | Clinic/Center | 1500 Route 112, Bldg 5, Port Jefferson Station, NY 11776-8054 | 2014-01-14 |
| 1720326077 | Away From Home Senior Day Care | Custodial Care Facility | 1500 Route 112, Building 6, Suite A, Port Jefferson Station, NY 11776-8054 | 2013-01-22 |
| 1053636431 | Jennifer Marie Diaz | Allergy & Immunology | 1500 Route 112, Bldg. 4 - 2nd Floor, Port Jefferson Station, NY 11776-8054 | 2010-03-29 |
| 1689800633 | Thomas P. Erhart Do PC | Obstetrics & Gynecology | 1500 Route 112, Bldg 11, Suite B, Port Jefferson Station, NY 11776-3060 | 2009-06-04 |
| 1851527972 | Washington Park Women's Health PC | Obstetrics & Gynecology | 1500 Route 112, Bldg 11 Suite A, Port Jefferson Station, NY 11776-3060 | 2009-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205304219 | Melissa E Germano | Acupuncturist | 5225 Nesconset Highway Rte 347, Davis Professional Park Building 1 Suite 1, Port Jefferson Station, NY 11776 | 2018-11-07 |
| 1366962185 | Michael Louis Scicchitano Sr. | Physical Therapist | 3 Colgate Street, Port Jefferson Station, NY 11776 | 2017-06-22 |
| 1063969517 | Dana Adamkiewicz | Acupuncturist | 432 North Bicycle Path, Port Jefferson Station, NY 11776 | 2016-09-01 |
| 1538531819 | Jacqueline Rambo | Specialist | 5225 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2015-10-26 |
| 1821474297 | Michael Leuci | Social Worker | 3 Premier Court, Port Jefferson Station, NY 11776 | 2015-08-07 |
| 1578978078 | Carol A. Palmer I | Acupuncturist | 34 Champlain St, Port Jefferson Station, NY 11776 | 2014-06-24 |
| 1659783371 | Janette M Sperandeo | Nurse Practitioner | 5 Roosevelt Avenue, Port Jefferson Station, NY 11776 | 2014-05-29 |
| 1578973079 | James Buchrieser | Specialist | 525 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2014-05-06 |
| 1871923227 | Duran Thomas Murphy | Licensed Practical Nurse | 8 Carolyn Road, Port Jefferson Station, NY 11776 | 2013-11-22 |
| 1699104562 | Julio Genao | Massage Therapist | 213 Jayne Blvd, Portjefferson Station, NY 11776 | 2013-11-01 |
| Find all providers in zip 11776 | ||||
| Taxonomy Code | 207YS0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Sleep Medicine |
| An Otolaryngologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609431212 | Sall Sleep Medicine Pllc | Otolaryngology | 4000 Medical Center Dr Ste 404, Fayetteville, NY 13066-6631 | 2019-05-08 |
| 1124312020 | Metropolitan Medical Solutions, P.C. | Otolaryngology | 257 E Middle Country Rd, Smithtown, NY 11787-2807 | 2011-06-08 |
| 1386811479 | Charles P Kimmelman Md Facs PC | Otolaryngology | 993 Park Ave, Ste C, New York, NY 10028-0809 | 2008-05-08 |
| 1417144239 | Cortland Ent, PC | Otolaryngology | 64 Pomeroy St, Cortland, NY 13045-2708 | 2007-09-25 |
| 1174749733 | Steven A Hemmerdinger | Otolaryngology | 1055 Saw Mill River Rd, Suite 101, Ardsley, NY 10502-1045 | 2007-04-18 |
| 1467675181 | Melissa M. Mortensen-welch | Otolaryngology | 37 Research Way, Stony Brook Surgical Associates, East Setauket, NY 11733-9200 | 2007-04-11 |
| 1508810581 | James F Chmiel | Otolaryngology | 6041 Transit Rd, Suite 101, E. Amherst, NY 14051 | 2006-05-22 |
| City | PORT JEFFERSON STATION |
| Zip Code | 11776 |
Please comment or provide details below to improve the information on LEE MERRICK SHANGOLD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.