NPIMap

Organization Active NPI

Brookhaven Memorial Hospital Medical Center, Inc.

Doing business as Brookhaven Memorial Hospital Home Health Agency

  • Home Health Agency
  • Patchogue, NY
National Provider Identifier
1104823996
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
5123600 Issued in NY
Legal business name
BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER, INC.
Doing business as
Brookhaven Memorial Hospital Home Health Agency
Practice address
103 West Main Street
Patchogue, NY 11772-3003
Phone
(631) 758-3600
Fax
(631) 758-3615
NPI assigned
Jul 7, 2005
Last updated
Aug 26, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
Brenda J Farrell
Title
Vice President & Cfo
Phone
(631) 654-7175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5123600 NY Primary

Addresses

Primary practice location

103 West Main Street
Patchogue, NY 11772-3003

Mailing address

103 West Main Street
Patchogue, NY 11772-3003
Phone (631) 758-3600

Other identifiers 2

IdentifierTypeStateIssuer
00245529MedicaidNY
000086OtherNYEMPIRE BLUE CROSS

Other names 1

  • Brookhaven Memorial Hospital Home Health Agency Doing business as

National Provider Directory

National Provider Directory
Part of
Brookhaven Emergecny PH

Locations

103 W Main St
Patchogue, NY 11772
Phone (631) 687-4188

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1104823996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WEST MAIN STREET",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723003",
            "telephone_number": "631-758-3600",
            "fax_number": "631-758-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WEST MAIN STREET",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723003",
            "telephone_number": "631-758-3600",
            "fax_number": "631-758-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER INC",
        "enumeration_date": "2005-07-07",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "631-654-7175"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "5123600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00245529",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "000086",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookhaven Memorial Hospital Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookhaven Memorial Hospital Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.