Individual provider Active NPI

Jack Oats, M.D.

  • Ophthalmology Physician
  • East Setauket, NY
National Provider Identifier
1114921558
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
170024 Issued in NY
Practice address
4 Technology Dr
Suite 150
East Setauket, NY 11733-4080
Phone
(631) 941-1400
Fax
(631) 941-1476
NPI assigned
Jun 13, 2005
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 170024 NY Primary

Addresses

Primary practice location

4 Technology Dr
Suite 150
East Setauket, NY 11733-4080

Mailing address

825 E Gate Blvd
Ste 111
Garden City, NY 11530-2124
Phone (516) 804-5200

Other identifiers 1

IdentifierTypeStateIssuer
01550090MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000456 NY Practitioner - Ophthalmology 1254470313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Loyola University of Chicago, Stritch School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Hospital Rd
Suite 216
East Patchogue, NY 11772-8814
Phone (631) 828-7100

125 Oakland Ave
Suite 101
Port Jefferson, NY 11777-2130
Phone (631) 828-7100

2000 N Village Ave
Rockville Centre, NY 11570-1078
Phone (516) 766-2519

4 Technology Dr
Suite 150
East Setauket, NY 11733-4085
Phone (631) 941-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
170024NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Long Island Ophthalmology CurrentSince Jul 1, 1997 Accepting new patients
Ophthalmic Consultants of Long Island Ophthalmology CurrentSince Jul 1, 1997 Accepting new patients

Locations

100 Hospital Rd
Ste 216
East Patchogue, NY 11772
Phone (631) 475-5511

4 Technology Dr
Ste 150
East Setauket, NY 11733
Phone (631) 941-1400

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

125 Oakland Ave
Ste 101
Port Jefferson, NY 11777
Phone (631) 828-7100

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

2000 N Village Ave
#13202
Rockville Ctr, NY 11570
Phone (516) 766-2519

2000 N Village Ave
Ste 302
Rockville Ctr, NY 11570
Phone (516) 766-2519

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jack.oats.p1@direct.ocli.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1114921558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD",
            "address_2": "STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302124",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "address_2": "SUITE 150",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334080",
            "telephone_number": "631-941-1400",
            "fax_number": "631-941-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OATS",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "170024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01550090",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.