NPIMap

Organization Active NPI

County of Suffolk

  • Skilled Nursing Facility
  • Yaphank, NY
National Provider Identifier
1104868702
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5151304N Issued in NY
Legal business name
COUNTY OF SUFFOLK
Practice address
14 Glover Dr
Yaphank, NY 11980-1204
Phone
(631) 852-4400
Fax
(631) 852-4475
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Mr. John T Digilio Jr.
Title
Executive Director
Phone
(631) 852-4404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5151304N NY Primary

Addresses

Primary practice location

14 Glover Dr
Yaphank, NY 11980-1204

Mailing address

14 Glover Dr
Yaphank, NY 11980-1204
Phone (631) 852-4400

Other identifiers 3

IdentifierTypeStateIssuer
01935322MedicaidNY
00310994MedicaidNY
W79281OtherMEDICARE FEE FOR SERVICE

Other names 1

  • JOHN J. FOLEY SKILLED NURSING FACILITY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000525 NY Part B Supplier - Clinic/Group Practice 2264344316 Receives reassigned benefits from 17 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Farmingville, NY; Riverhead, NY; Yaphank, NY

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1104868702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GLOVER DR",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119801204",
            "telephone_number": "631-852-4400",
            "fax_number": "631-852-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 GLOVER DR",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119801204",
            "telephone_number": "631-852-4400",
            "fax_number": "631-852-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SUFFOLK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "DIGILIO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-852-4404",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5151304N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01935322",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310994",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FEE FOR SERVICE",
            "identifier": "W79281",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHN J. FOLEY SKILLED NURSING FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yaphank, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.