Cosmetic Surgery of New York PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

COSMETIC SURGERY OF NEW YORK PC

Practice address

4616 Nesconset Hwy
Port Jefferson Station, NY 11776-2563

Phone

(631) 473-7070

Fax

(631) 331-2654

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Alan Jacobs, M.D.NPI 1194810390

Title

Surgeon

Phone

(631) 473-7070

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Robert A Jacobs, M.D.

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1194810390
  Medicare reassignment Care Compare group NPD Authorized official
• Hillard Warm, M.D.

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1922150739
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124229562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762563",
            "telephone_number": "631-473-7070",
            "fax_number": "631-331-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762563",
            "telephone_number": "631-473-7070",
            "fax_number": "631-331-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC SURGERY OF NEW YORK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "631-473-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "A400036602",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Core Chiropractic Rehabilitation PC
• Gina Cornicelli
• Stephanie Corrado, PA-C
• Jennifer Cortes
• Leslie Cortez, BS
• Jennifer L Costa, AUD.
• Siobhan Bridget Costigliola
• Victoria A Courten, LMHC
• Jennifer Elizabeth Crabbe, LMSW
• Michelle Crain, LPN

• Specialist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.