Active NPI
Good Samaritan Hospital Medical Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Lindenhurst, NY
National Provider Identifier
1124187349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- GOOD SAMARITAN HOSPITAL MEDICAL CENTER
- Practice address
- 185 S 10TH St
Lindenhurst, NY 11757-4505 - Phone
- (631) 224-8510
- NPI assigned
- Dec 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William Allison
- Title
- Cheif Financial Officer
- Phone
- (631) 376-4003
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
185 S 10TH St
Lindenhurst, NY 11757-4505
Mailing address
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005308 | Other | NY | BLUE CROSS |
| 00274346 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1245369600000",
"number": "1124187349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MONTAUK HWY",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954927",
"telephone_number": "631-376-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 S 10TH ST",
"city": "LINDENHURST",
"state": "NY",
"postal_code": "117574505",
"telephone_number": "631-224-8510"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-06",
"last_updated": "2009-06-19",
"status": "A",
"authorized_official_last_name": "ALLISON",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "CHEIF FINANCIAL OFFICER",
"authorized_official_telephone_number": "631-376-4003",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "005308",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00274346",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lindenhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.