NPIMap

Organization Active NPI

CHS Physician Partners, PC

Doing business as Woodmere Medical Practice

  • Pulmonary Disease Physician
  • Woodmere, NY
National Provider Identifier
1376889386
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
155661 Issued in NY
Legal business name
CHS PHYSICIAN PARTNERS, PC
Doing business as
Woodmere Medical Practice
Practice address
923 Broadway
Woodmere, NY 11598-1739
Phone
(516) 218-2163
Fax
(516) 218-2165
NPI assigned
Dec 19, 2012
Last updated
Jul 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CHS PHYSICIAN PARTNERS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Dr. Jack Soterakis, MD
Title
President
Phone
(516) 562-6231

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X 155661 NY
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 155661 NY Primary

Addresses

Primary practice location

923 Broadway
Woodmere, NY 11598-1739

Mailing address

PO Box 95000-6625
Philadelphia, PA 19195-6625
Phone (631) 465-6297

Other names 1

  • WOODMERE MEDICAL PRACTICE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708000027 NY Part B Supplier - Clinic/Group Practice 7618955667 Receives reassigned benefits from 1,098 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Tax ID family
CHS Physician Partners PC10 organizations share this tax ID, including this one
Part of
CHS Physician Partners PC

Other organizations with this tax ID 9

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

Locations

923 Broadway
Woodmere, NY 11598
Phone (516) 218-2163

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1376889386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-6625",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191956625",
            "telephone_number": "631-465-6297",
            "fax_number": "631-465-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 BROADWAY",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981739",
            "telephone_number": "516-218-2163",
            "fax_number": "516-218-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHYSICIAN PARTNERS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS PHYSICIAN PARTNERS, PC",
        "enumeration_date": "2012-12-19",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SOTERAKIS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-562-6231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "155661",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "155661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOODMERE MEDICAL PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WOODMERE MEDICAL PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodmere, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.