NPIMap

Organization Active NPI

Millennium Medical Professionals, PLLC

  • Cardiovascular Disease Physician
  • Smithtown, NY
National Provider Identifier
1114364510
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MILLENNIUM MEDICAL PROFESSIONALS, PLLC
Practice address
496 Smithtown Byp
Suite 101
Smithtown, NY 11787-5010
Phone
(631) 979-8880
Fax
(631) 979-8064
NPI assigned
May 28, 2013
Last updated
May 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Dr. Jyoti P Ganguly, M.D.NPI 1366456113
Title
President
Phone
(631) 979-8880

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
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU

Addresses

Primary practice location

496 Smithtown Byp
Suite 101
Smithtown, NY 11787-5010

Mailing address

496 Smithtown Byp
Suite 101
Smithtown, NY 11787-5010
Phone (631) 979-8880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130926000145 NY Part B Supplier - Clinic/Group Practice 3971747296 Receives reassigned benefits from 11 practitioners
Practice locations: Port Jefferson Station, NY; Smithtown, NY

National Provider Directory

National Provider Directory

Locations

5225 Route 347
Ste 23
Port Jefferson Station, NY 11776
Phone (631) 473-8880

496 Smithtown Byp
Ste 101
Smithtown, NY 11787
Phone (631) 880-1365

Practitioners & affiliated clinicians

Practitioners 12

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": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1114364510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "SUITE 101",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875010",
            "telephone_number": "631-979-8880",
            "fax_number": "631-979-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "SUITE 101",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875010",
            "telephone_number": "631-979-8880",
            "fax_number": "631-979-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM MEDICAL PROFESSIONALS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "GANGULY",
        "authorized_official_first_name": "JYOTI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-979-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 May 12, 2014; 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.