NPIMap

Organization Active NPI

North Shore Immediate Medical Care P.C.

  • Family Medicine Physician
  • Port Jefferson Station, NY
National Provider Identifier
1225253537
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
185255 Issued in NY
Legal business name
NORTH SHORE IMMEDIATE MEDICAL CARE P.C.
Practice address
509 Patchogue Rd
Port Jefferson Station, NY 11776-1006
Phone
(631) 331-1100
Fax
(631) 331-0223
NPI assigned
Apr 13, 2007
Last updated
Mar 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Authorized official

Name
Dr. Antoun Saba Mitromaras, MDNPI 1841263274
Title
President
Phone
(631) 331-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 185255 NY Primary

Addresses

Primary practice location

509 Patchogue Rd
Port Jefferson Station, NY 11776-1006

Mailing address

509 Patchogue Rd
Port Jefferson Station, NY 11776-1006
Phone (631) 331-1100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1225253537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 PATCHOGUE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761006",
            "telephone_number": "631-331-1100",
            "fax_number": "631-331-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 PATCHOGUE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761006",
            "telephone_number": "631-331-1100",
            "fax_number": "631-331-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE IMMEDIATE MEDICAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "MITROMARAS",
        "authorized_official_first_name": "ANTOUN",
        "authorized_official_middle_name": "SABA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-331-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "185255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.