NPIMap

Organization Active NPI

Southwest Suffolk Medical, P.C.

  • Surgical Oncology Physician
  • Smithtown, NY
National Provider Identifier
1104096049
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 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
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X
Surgical Oncology Physician 2086X0206X Primary

Addresses

Primary practice location

48 Route 25a
Smithtown, NY 11787-1431

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

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

20507 Hillside Ave
Ste 12
Hollis, NY 11423
Phone (718) 464-6700

425 National Blvd
Long Beach, NY 11561
Phone (516) 353-3387

1719 N Ocean Ave
Ste D
Medford, NY 11763
Phone (631) 758-5555

635 Belle Terre Rd
Ste 106
Port Jefferson Station, NY 11777
Phone (631) 675-2810

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

48 Route 25A
Ste 102
Smithtown, NY 11787
Phone (631) 360-1720

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

48 Route 25A
Ste A
Smithtown, NY 11787

732 Smithtown Byp
Ste 103
Smithtown, NY 11787
Phone (631) 265-5501

555 Little East Neck Rd N
West Babylon, NY 11704
Phone (631) 587-9355

Practitioners & affiliated clinicians

Practitioners 349

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 349

NPI Registry JSON

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

{
    "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": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.