NPIMap

Organization Active NPI

Terryville Medical Associates

  • Medical Specialty Clinic/Center
  • Port Jefferson Station, NY
National Provider Identifier
1295714277
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
09600 Issued in NY
Legal business name
TERRYVILLE MEDICAL ASSOCIATES
Practice address
116 Terryville Rd
Port Jefferson Station, NY 11776-1329
Phone
(631) 928-2002
Fax
(631) 928-4934
NPI assigned
Jan 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Biasetti, M.D.
Title
Partner
Phone
(631) 928-2002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 09600 NY Primary

Addresses

Primary practice location

116 Terryville Rd
Port Jefferson Station, NY 11776-1329

Mailing address

PO Box 994
Port Jefferson Station, NY 11776-0847
Phone (631) 928-2002

National Provider Directory

National Provider Directory
Tax ID family
Terryville Medical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295714277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 994",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117760847",
            "telephone_number": "631-928-2002",
            "fax_number": "631-928-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 TERRYVILLE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761329",
            "telephone_number": "631-928-2002",
            "fax_number": "631-928-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRYVILLE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BIASETTI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-928-2002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "09600",
            "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 Aug 22, 2020; 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.