Setauket Surgery, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

221306 Issued in NY

Legal business name

SETAUKET SURGERY, PC

Practice address

4 Technology Dr
Suite 220
East Setauket, NY 11733-4080

Phone

(631) 476-9296

Fax

(631) 476-9298

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Hesham M Atwa, MDNPI 1841286788

Title

Owner

Phone

(631) 476-9296

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

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

• Ting-Kin J Leung, D.O.

  • Surgery Physician
  • East Setauket, NY
  • NPI 1467732933
  Medicare reassignment NPD
• Hesham Mahmoud Atwa, M.D.

  • Surgery Physician
  • Port Jefferson, NY
  • NPI 1841286788
  NPD (past) Authorized official

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1104287432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DRIVE",
            "address_2": "SUITE 220",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334085",
            "telephone_number": "631-476-9296",
            "fax_number": "631-476-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "address_2": "SUITE 220",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334080",
            "telephone_number": "631-476-9296",
            "fax_number": "631-476-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETAUKET SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "ATWA",
        "authorized_official_first_name": "HESHAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-476-9296",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "221306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Setauket Massage Therapy PC
• Setauket Medical & Rehabilitation PC
• Setauket Medical, PC
• Setauket Nurse Practitioner in Family Health P.C.
• Setauket Primary Medical Care PC
• Debra A. Sfakis, REGISTERED NURSE
• Shruti M Shah
• Jennifer J Shanahan, R.D., C.D.N.
• Terry S Shapiro, D.M.D.
• Kimberly Mae Sheehan, M.A/CCC/SLP

• Surgery Physician in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.