Individual provider Active NPI

Chethan Jinka Sathya, M.D.

  • Pediatric Surgery Physician
  • New Hyde Park, NY
National Provider Identifier
1083146567
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
036.142275 Issued in IL
Practice address
26901 76TH Ave
New Hyde Park, NY 11040-1433
Phone
(718) 470-3000
NPI assigned
Apr 3, 2017
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 036.142275 IL Primary

Addresses

Primary practice location

26901 76TH Ave
New Hyde Park, NY 11040-1433

Mailing address

26901 76TH Ave
New Hyde Park, NY 11040-1433
Phone (718) 470-3000

Other practice location 1

Ann and Robert H. Lurie Children's Hospital of Chicago
225 E Chicago Avenue
Chicago, IL 60611-2605
Phone (312) 227-4210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200123001864 NY Practitioner - General SurgeryPractitioner - Pediatric Medicine 2466887377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.142275ILMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Nov 23, 2019 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

1111 Marcus Ave
Ste M15
New Hyde Park, NY 11042
Phone (516) 601-7200

26901 76th Ave
Ste 158
New Hyde Park, NY 11040
Phone (718) 470-3135

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: csathya67708@northwell.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1083146567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "718-470-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26901 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "718-470-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ann and Robert H. Lurie Children's Hospital of Chicago",
            "address_2": "225 E Chicago Avenue",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112605",
            "country_code": "US",
            "telephone_number": "312-227-4210",
            "fax_number": "312-227-9678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SATHYA",
        "first_name": "CHETHAN",
        "middle_name": "JINKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": "036.142275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.