NPIMap

Organization Active NPI

Red Shirt Medical Associates, PC

  • Anesthesiology Physician
  • Port Jefferson Station, NY
National Provider Identifier
1184028292
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
RED SHIRT MEDICAL ASSOCIATES, PC
Practice address
931 Hallock Ave
Port Jefferson Station, NY 11776-1228
Phone
(347) 417-9081
Fax
(718) 732-2434
NPI assigned
Oct 17, 2014
Last updated
Oct 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Mrs. Jessica Daley
Title
Account Executive
Phone
(347) 417-9081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

931 Hallock Ave
Port Jefferson Station, NY 11776-1228

Mailing address

PO Box 992
Port Jefferson Station, NY 11776-0845
Phone (347) 417-9081

National Provider Directory

National Provider Directory

Locations

931 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 331-7200

Practitioners & affiliated clinicians

Practitioners 4

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": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1184028292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 992",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117760845",
            "telephone_number": "347-417-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761228",
            "telephone_number": "347-417-9081",
            "fax_number": "718-732-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED SHIRT MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "DALEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ACCOUNT EXECUTIVE",
        "authorized_official_telephone_number": "347-417-9081",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.