NPIMap

Organization Active NPI

Developmental Disabilities Institute

  • Early Intervention Provider Agency
  • Ronkonkoma, NY
National Provider Identifier
1215207162
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
580801997261 Issued in NY
Legal business name
DEVELOPMENTAL DISABILITIES INSTITUTE
Practice address
90 Airpark Dr.
Ronkonkoma, NY 11779-7360
Phone
(631) 366-5876
NPI assigned
Jan 10, 2012
Last updated
Aug 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Authorized official

Name
Mrs. Sophia Samuels
Title
Cfo
Phone
(631) 366-2960

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Early Intervention Provider Agency 252Y00000X 580801997261 NY Primary

Addresses

Primary practice location

90 Airpark Dr.
Ronkonkoma, NY 11779-7360

Mailing address

99 Hollywood Drive
Smithtown, NY 11787-3135
Phone (631) 366-5876

Other identifiers 1

IdentifierTypeStateIssuer
03565455MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Developmental Disabilities Institute17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1215207162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HOLLYWOOD DRIVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873135",
            "telephone_number": "631-366-5876",
            "fax_number": "631-366-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 AIRPARK DR.",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797360",
            "telephone_number": "631-366-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DISABILITIES INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-366-2960",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "580801997261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03565455",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 16, 2016; 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.