Organization Active NPI

Frank S Segreto MD PC

Doing business as Elite Sports

  • Orthopaedic Surgery Physician
  • Ronkonkoma, NY
National Provider Identifier
1205170123
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
FRANK S SEGRETO MD PC
Doing business as
Elite Sports
Practice address
3385 Veterans Memorial Hwy
Suite I
Ronkonkoma, NY 11779-7660
Phone
(631) 737-6767
Fax
(631) 737-5068
NPI assigned
Nov 15, 2012
Last updated
Feb 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Authorized official

Name
Joanne Quinn
Title
Office Manager
Phone
(631) 737-6767

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary
Physical Therapist 225100000X

Addresses

Primary practice location

3385 Veterans Memorial Hwy
Suite I
Ronkonkoma, NY 11779-7660

Mailing address

3385 Veterans Memorial Hwy
Suite I
Ronkonkoma, NY 11779-7660
Phone (631) 737-6767

Other names 1

  • Elite Sports Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130308000467 NY Part B Supplier - Clinic/Group Practice 2163677501 Receives reassigned benefits from 3 practitioners
Practice locations: Ronkonkoma, NY

National Provider Directory

National Provider Directory

Locations

3385 Veterans Memorial Hwy
Ste I
Ronkonkoma, NY 11779
Phone (631) 665-4560

Practitioners & affiliated clinicians

Practitioners 5

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": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1205170123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 VETERANS MEMORIAL HWY",
            "address_2": "SUITE I",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797660",
            "telephone_number": "631-737-6767",
            "fax_number": "631-737-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 VETERANS MEMORIAL HWY",
            "address_2": "SUITE I",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797660",
            "telephone_number": "631-737-6767",
            "fax_number": "631-737-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANK S SEGRETO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-737-6767"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Sports",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.