NPIMap

Organization Active NPI

CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
National Provider Identifier
1164585725
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
107339 Issued in NY
Legal business name
CHS PHYSICIAN PARTNERS, P.C
Practice address
100 Port Washington Blvd
Suite 105
Roslyn, NY 11576-1347
Phone
(516) 390-9640
Fax
(516) 390-9650
NPI assigned
Dec 18, 2006
Last updated
Jul 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Jack Soterakis, M.D.NPI 1598768624
Title
President
Phone
(516) 562-6231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 161798 NY
Cardiovascular Disease Physician 207RC0000X 107339 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Suite 105
Roslyn, NY 11576-1347

Mailing address

PO Box 95000-6625
Philadelphia, PA 19195-6625
Phone (631) 465-6297

Other identifiers 2

IdentifierTypeStateIssuer
01243636MedicaidNY
DC4425OtherNYMC RR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708000027 NY Part B Supplier - Clinic/Group Practice 7618955667 Receives reassigned benefits from 1,098 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory

Locations (25 of 144)

317 Broadway
Amityville, NY 11701
Phone (631) 361-7444

400 W Main St
Ste 33
Babylon, NY 11702

661 Deer Park Ave
Babylon, NY 11702
Phone (631) 376-3880

79 Deer Park Ave
Babylon, NY 11702
Phone (631) 587-0574

830 Atlantic Ave
Ste B
Baldwin, NY 11510

15 Park Ave
Ste 200
Bay Shore, NY 11706
Phone (631) 224-8518

1850 Sunrise Hwy
Fl 2
Bay Shore, NY 11706

1850 Sunrise Hwy
Ste 2
Bay Shore, NY 11706

332 E Main St
Bay Shore, NY 11706
Phone (631) 665-3737

375 E Main St
Ste 20
Bay Shore, NY 11706
Phone (516) 665-4118

45 Park Ave
Bay Shore, NY 11706
Phone (631) 376-0700

4277 Hempstead Tpke
Ste 103
Bethpage, NY 11714

4277 Hempstead Tpke
Ste 207
Bethpage, NY 11714

2212 Middle Country Rd
Centereach, NY 11720

500 Commack Rd
Ste 1500
Commack, NY 11725

500 Commack Rd
Ste B
Commack, NY 11725

500 Commack Rd
Ste D
Commack, NY 11725

500 Commack Rd
Ste E
Commack, NY 11725
Phone (631) 435-0110

66 Commack Rd
Bldg 1
Commack, NY 11725

66 Commack Rd
Ste 300
Commack, NY 11725
Phone (631) 486-5286

2017 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-7444

2017 Deer Park Ave
Ste 1
Deer Park, NY 11729
Phone (631) 376-3251

2017 Deer Park Ave
Ste 2
Deer Park, NY 11729

860 Grand Blvd
Deer Park, NY 11729
Phone (631) 243-7770

220 E Main St
Ste 1
East Islip, NY 11730
Phone (631) 969-4590

Practitioners & affiliated clinicians

Practitioners 1,100

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.

View all 1,100

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1164585725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-6625",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191956625",
            "telephone_number": "631-465-6297",
            "fax_number": "631-465-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "SUITE 105",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "516-390-9640",
            "fax_number": "516-390-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHYSICIAN PARTNERS, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SOTERAKIS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-562-6231",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "161798",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "107339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01243636",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RR",
            "identifier": "DC4425",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.