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1619962586

NPI Code Detail

MEDICARE: SCOTT IPPOLITO M.D.

MEDICARE: SCOTT IPPOLITO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	179201	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000059757	OTHER	NY	GHI HMO
2	050710000017	OTHER	NY	FIDELIS
3	1000024409	OTHER	NY	AFFINITY
4	113565450	OTHER	NY	GREAT WEST
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	113565450	OTHER	NY	FIRST HEALTH
7	2984981	OTHER	NY	AETNA HMO
8	AA71641	OTHER	NY	MDNY
9	0D4541	OTHER	NY	BCBS
10	113565450	OTHER	NY	MAGNACARE
11	5998030	OTHER	NY	GHI PPO
12	P2214590	OTHER	NY	OXFORD
13	179201	OTHER	NY	HIP
14	2C9258	OTHER	NM	HEALTHNET
15	4278367	OTHER	NY	AETNA PPO
16	BEECH STREET	OTHER	NY	113565450
17	CIGNA	OTHER	NY	5874507
18	MULTIPLAN	OTHER	NM	113565450

General Provider Information

NPI Number	:	1619962586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT IPPOLITO M.D.

Provider Business Mailing Address
First Line	:	1 HEALTHY WAY
Second Line	:	ATTN: PHYSICIAN BILLING
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1551
Country	:	US
Telephone Number	:	516-255-8400
Fax Number	:	516-255-4672

Provider Business Practice Location Address
First Line	:	196 MERRICK RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1420
Country	:	US
Telephone Number	:	516-255-8400
Fax Number	:	516-255-8453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	04/27/2010

Similar Medicare Providers

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Practice Location Address:

196 MERRICK RD
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11572-1420

Practice Phone: 516-255-8400
Practice Fax: 516-255-8450

1487649257 — DR. SUNITA K. JAIN M.D.
Practice Location Address:

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1912992785 — DR. EMAD S. HANNA M.D.
Practice Location Address:

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Practice Fax: 516-255-4672

1801881677 — DR. LINDA ROETHEL M.D.
Practice Location Address:

196 MERRICK RD
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11572-1420

Practice Phone: 516-255-1616
Practice Fax: 516-255-4672

1952396723 — SAMUEL SANDOWSKI M.D.
Practice Location Address:

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1942295720 — LAWRENCE SOKOLSKY M.D.
Practice Location Address:

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Directions to “ SCOTT IPPOLITO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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