Organization Active NPI

Colon and Rectal Surgeons of Long Island, P.C.

  • Colon & Rectal Surgery Physician
  • East Setauket, NY
National Provider Identifier
1114165909
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
142014 Issued in NY
Legal business name
COLON AND RECTAL SURGEONS OF LONG ISLAND, P.C.
Practice address
3400 Nesconset Hwy
Suite 100
East Setauket, NY 11733-3327
Phone
(631) 689-2600
Fax
(631) 689-2943
NPI assigned
Feb 2, 2009
Last updated
Feb 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Authorized official

Name
Dr. Arnold R Leiboff, M.D.NPI 1154322188
Title
President
Phone
(631) 689-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 142014 NY
Colon & Rectal Surgery Physician 208C00000X 142014 NY Primary

Addresses

Primary practice location

3400 Nesconset Hwy
Suite 100
East Setauket, NY 11733-3327

Mailing address

3400 Nesconset Hwy
Suite 100
East Setauket, NY 11733-3327
Phone (631) 689-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090209000206 NY Part B Supplier - Clinic/Group Practice 4981769932 Receives reassigned benefits from 1 practitioner
Practice locations: East Setauket, NY

National Provider Directory

National Provider Directory

Locations

3400 Nesconset Hwy
Ste 100
East Setauket, NY 11733
Phone (631) 689-2600

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": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1114165909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NESCONSET HWY",
            "address_2": "SUITE 100",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327",
            "telephone_number": "631-689-2600",
            "fax_number": "631-689-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NESCONSET HWY",
            "address_2": "SUITE 100",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327",
            "telephone_number": "631-689-2600",
            "fax_number": "631-689-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON AND RECTAL SURGEONS OF LONG ISLAND, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "LEIBOFF",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-689-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "142014",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "142014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.