Good Samaritan Hospital Medical Center

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

GOOD SAMARITAN HOSPITAL MEDICAL CENTER

Practice address

929 Sunrise Hwy
Bay Shore, NY 11706-5907

Phone

(631) 224-8510

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William Allison

Title

Chief Financial Officer

Phone

(631) 376-4003

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1194884312",
    "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": "929 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065907",
            "telephone_number": "631-224-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF 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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03000328",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "005308",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nanette Maria Gonzalez, LMHC
• Paola Gonzalez
• Richard Gonzalez
• Victoria Gonzalez, MD
• Virginia Elizabeth Gonzalez, MD
• Good Samaritan Hospital Medical Center
• Good Samaritan Hospital Medical Center
• Alexandra Isabel Goodwin, MD
• Michael Gorczycki, PA-C
• Bernard N. Gordy, LAC.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.

Verify at the official NPI Registry.