NPIMap

Southwest Suffolk Medical, P.C.

Organization Active NPI Surgical Oncology Physician · Smithtown, NY

NPI 1104096049 · NPPES record last updated Apr 28, 2008

Key facts

NPI
1104096049
Entity type
Organization (NPI type 2)
Primary specialty
Surgical Oncology Physician 2086X0206X
Legal business name
SOUTHWEST SUFFOLK MEDICAL, P.C.
Practice address
48 Route 25a
Smithtown, NY 11787-1431
Phone
(631) 862-3000
Fax
(631) 224-8560
NPI assigned
Mar 6, 2008
Organization subpart
No

Authorized official

Name
Mr. Dave M Hannigan Jr.
Title
Manager of Physicians Bill
Phone
(631) 224-8533

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 349

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 349

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090225000297 NY Part B Supplier - Clinic/Group Practice 0244396349 Receives reassigned benefits from 340 practitioners
2 other NPIs on this enrollment

National Provider Directory

Locations

350 W Main St
Babylon, NY 11702
Phone (631) 661-2277

332 E Main St
Bay Shore, NY 11706
Phone (631) 665-3737

250 Patchogue Yaphank Rd
Ste 11E
East Patchogue, NY 11772

701 Route 25A
Mount Sinai, NY 11766
Phone (631) 331-4403

75 N Country Rd
Ste 1001
Port Jefferson, NY 11777
Phone (631) 689-1400

200 Belle Terre Rd
Ste 300
Prt Jefferson, NY 11777
Phone (631) 331-0776

36 Osprey Ave
Riverhead, NY 11901
Phone (631) 574-8660

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

48 Route 25A
Ste 210
Smithtown, NY 11787
Phone (516) 360-1980

48 Route 25A
Ste A
Smithtown, NY 11787

48 Route 25A
Ste 303
Smithtown, NY 11787
Phone (631) 382-4833

48 Route 25A
Ste 202
Smithtown, NY 11787
Phone (631) 862-3610

101 Hospital Rd
Stony Brook, NY 11794
Phone (631) 474-6000

1175 Montauk Hwy
West Islip, NY 11795
Phone (631) 265-4485

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Surgical Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086X0206X Yes

Addresses

Primary practice location

48 Route 25a
Smithtown, NY 11787-1431

Mailing address

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 862-3000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 28, 2008.

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1104096049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871431",
            "telephone_number": "631-862-3000",
            "fax_number": "631-224-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871431",
            "telephone_number": "631-862-3000",
            "fax_number": "631-224-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SUFFOLK MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "HANNIGAN",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER OF PHYSICIANS BILL",
        "authorized_official_telephone_number": "631-224-8533",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

All providers in Smithtown, NY · Surgical Oncology Physician in New York

Sources for this page

Verify at the official NPI Registry.