NPIMap

Organization Active NPI

Blue Harbor Medical PC

  • Surgery Physician
  • East Setauket, NY
National Provider Identifier
1376940742
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
254899 Issued in NY
Legal business name
BLUE HARBOR MEDICAL PC
Practice address
4 Technology Dr
Suite 240
East Setauket, NY 11733-4080
Phone
(631) 675-6865
Fax
(631) 403-4737
NPI assigned
Dec 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Karim A Paracha, MDNPI 1316128937
Title
Owner
Phone
(631) 675-6865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 254899 NY Primary

Addresses

Primary practice location

4 Technology Dr
Suite 240
East Setauket, NY 11733-4080

Mailing address

PO Box 2127
Saint James, NY 11780-2280
Phone (631) 675-6865

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.

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1376940742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2127",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802280",
            "telephone_number": "631-675-6865",
            "fax_number": "631-403-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "address_2": "SUITE 240",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334080",
            "telephone_number": "631-675-6865",
            "fax_number": "631-403-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HARBOR MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "PARACHA",
        "authorized_official_first_name": "KARIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-675-6865",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "254899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.