NPIMap

Organization Active NPI

Southside Hospital

  • Primary Care Clinic/Center
  • Central Islip, NY
National Provider Identifier
1184798977
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
006564-1 Issued in NY
Legal business name
SOUTHSIDE HOSPITAL
Practice address
45 W Suffolk Ave
Central Islip, NY 11722-2143
Phone
(631) 853-2710
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Douglas A. Riggs, RPACNPI 1215001011
Title
Rpac
Phone
(631) 853-2710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 006564-1 NY Primary

Addresses

Primary practice location

45 W Suffolk Ave
Central Islip, NY 11722-2143

Mailing address

7 Farmhouse Dr
Ridge, NY 11961-2169
Phone (631) 205-9626

Other names 1

  • Central Islip Health Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184798977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FARMHOUSE DR",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119612169",
            "telephone_number": "631-205-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W SUFFOLK AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222143",
            "telephone_number": "631-853-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIGGS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "RPAC",
        "authorized_official_telephone_number": "631-853-2710",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPAC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "006564-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Islip Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.