NPIMap

Organization Active NPI

Harbor View Medical Services PC

  • Rheumatology Physician
  • Port Jefferson, NY
National Provider Identifier
1205216066
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
HARBOR VIEW MEDICAL SERVICES PC
Practice address
75 N Country Rd
Suite 100
Port Jefferson, NY 11777-2119
Phone
(631) 686-7890
Fax
(631) 686-7972
NPI assigned
Jun 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Joan Faro
Title
President
Phone
(631) 473-1320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

75 N Country Rd
Suite 100
Port Jefferson, NY 11777-2119

Mailing address

100 Highlands Blvd
Box#9
Port Jefferson, NY 11777-2320
Phone (631) 686-7809

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090617000230 NY Part B Supplier - Clinic/Group Practice 5092865873 Receives reassigned benefits from 74 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stony Brook, NY; South Setauket, NY; Rocky Point, NY; Riverhead, NY; Port Jefferson Station, NY; Port Jefferson, NY; Bay Shore, NY; Brightwaters, NY…

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Harbor View Medical SRV PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

75 N Country Rd
Ste 100
Prt Jefferson, NY 11777
Phone 63147313204428

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8551/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1205216066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLANDS BLVD",
            "address_2": "BOX#9",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772320",
            "telephone_number": "631-686-7809",
            "fax_number": "631-686-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "address_2": "SUITE 100",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-686-7890",
            "fax_number": "631-686-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR VIEW MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "FARO",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-473-1320"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.