Individual provider Active NPI

Joseph B Quinn, MD

  • Pediatrics Physician
  • Hampton Bays, NY
National Provider Identifier
1215095906
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1536221 Issued in NY
Practice address
5 Squiretown Rd
Hampton Bays, NY 11946
Phone
(631) 728-5300
Fax
(631) 728-5360
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1536221 NY Primary

Addresses

Primary practice location

5 Squiretown Rd
Hampton Bays, NY 11946

Mailing address

45 Research Way
Stony Brook Childrens Services, Ufpc
East Setauket, NY 11733
Phone (631) 675-2125

Other identifiers 1

IdentifierTypeStateIssuer
00833216MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713002166 NY Practitioner - Pediatric Medicine 8527350404 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1536221NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Pediatrics CurrentSince Apr 27, 2016 Accepting new patients

Locations

5 Squiretown Rd
Hampton Bays, NY 11946
Phone (631) 728-5300

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

325 Meeting House Ln
Southampton, NY 11968
Phone (631) 283-7733

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1215095906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY",
            "address_2": "STONY BROOK CHILDRENS SERVICES, UFPC",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SQUIRETOWN RD",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "11946",
            "telephone_number": "631-728-5300",
            "fax_number": "631-728-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "JOSEPH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "1536221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00833216",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton Bays, NY

Sources for this page

Verify at the official NPI Registry.