NPIMap

Organization Active NPI

North Shore Internal Medicine, PC

  • Internal Medicine Physician
  • Port Jefferson Station, NY
National Provider Identifier
1285607069
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH SHORE INTERNAL MEDICINE, PC
Practice address
9 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1591
Phone
(631) 473-3900
Fax
(631) 474-4475
NPI assigned
Feb 10, 2006
Last updated
Sep 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Dr. Robert C Giacobbe, D.O.NPI 1154394930
Title
President
Phone
(631) 473-3900

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
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

9 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1591

Mailing address

9 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1591
Phone (631) 473-3900

National Provider Directory

National Provider Directory

Locations

112 Terryville Rd
Port Jefferson Station, NY 11776
Phone (631) 473-3900

9 Medical Dr
Ste B
Port Jefferson Station, NY 11776
Phone (631) 473-3900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2858/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1285607069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761591",
            "telephone_number": "631-473-3900",
            "fax_number": "631-474-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761591",
            "telephone_number": "631-473-3900",
            "fax_number": "631-474-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "GIACOBBE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-473-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Sep 4, 2013; 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.