NPIMap

Organization Active NPI

South Nassau Communities Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oceanside, NY
National Provider Identifier
1245201300
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SOUTH NASSAU COMMUNITIES HOSPITAL
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3000
Fax
(516) 632-3499
NPI assigned
Jan 27, 2006
Organization subpart
Yes
Parent organization
SOUTH NASSAU COMMUNITIES HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Authorized official

Name
Mr. Richard J. Murphy
Title
President & Ceo
Phone
(516) 632-3939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3000

Other identifiers 1

IdentifierTypeStateIssuer
02999613MedicaidNY

Other names 1

  • I/P Renal Dialysis Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130327000218 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 5092607846 Practice locations: Oceanside, NY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
So Nassau Comm Hosp3 organizations share this tax ID, including this one
Part of
So Nassau Comm Hosp

Other organizations with this tax ID 2

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mount Sinai South NassauOceanside, NY, CCN 330198 Hospital Operational/Managerial Control Jan 29, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1245201300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000",
            "fax_number": "516-632-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000",
            "fax_number": "516-632-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH NASSAU COMMUNITIES HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH NASSAU COMMUNITIES HOSPITAL",
        "enumeration_date": "2006-01-27",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "516-632-3939",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02999613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "I/P Renal Dialysis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.