Central Suffolk Hospital
Organization Active NPI General Acute Care Hospital · Riverhead, NY
NPI 1386649804 · NPPES record last updated Jul 31, 2025
Key facts
- NPI
- 1386649804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 5155000H (NY)
- Legal business name
- CENTRAL SUFFOLK HOSPITAL
- Practice address
- 1300 Roanoke Ave
Riverhead, NY 11901-2031 - Phone
- (631) 548-6000
- Fax
- (631) 548-6007
- NPI assigned
- Jun 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Michele L Cusack
- Title
- Senior Vice President & Cfo
- Phone
- (516) 321-6508
Owners & managing parties with NPI records 3
-
John D'Angelo, MD
-
David L Battinelli, M.D.
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 3
Member of 1
Facilities with the same owner 42
Practitioners 129
-
Shaikh Jauhar Ahmed, M.D.
-
Carolyn Alvarez, MD
-
Mariam Atia, DO
-
Carly Bushman, M.D.
-
Barjinder Singh Buttar, M.D.
-
Naveed Ahmed Chaudhry, M.D.
-
Nicolas Hernandez, M.D.
-
Stephen J John X, M.D.
-
Vency James Laurent, M.D.
-
Kenneth J Mayer, M.D.
-
Rajeev Balwant Patel, M.D.
-
Vaibhavi Patel, MD
-
Shirley Ponnaiya, DO
-
Joslin Thomas, MD
Affiliated clinicians 470
-
Naim Abrar, M.D.
-
Shah Nadir Ahmed, MD
-
Shaikh Jauhar Ahmed, M.D.
-
Adesola Anuoluwapo Akinyemi, MD, MPH
-
Huntley Joseph Alper, M.D.
-
Carolyn Alvarez, MD
-
Daniella Alviar, MD
-
Krista Amon, MS, PA-C
-
Lewis Seth Anreder, M.D.
-
Roni Aoun, M.D.
-
Tareq Aro, MD
-
Mohammad Athar, MD
-
Mariam Atia, DO
-
Matthew Austen, M.D.
-
David J. Axelrod, M.D.
Medicare Care Compare: Hospital
- Listed as
- Peconic Bay Medical Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0008773 | Peconic Bay Medical Center Laboratory | Compliance | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Hospital certification: CCN 330107
- Legal name
- CENTRAL SUFFOLK HOSPITAL
- Doing business as
- PECONIC BAY MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- May 26, 2023
- Beds
- 122
- Ownership / control type
- Other
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 26, 1945 in NY
- Enrollment address
- 1 Heroes Way
Riverhead, NY 11901-2054 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 25
| Name | Role | Since | Share |
|---|---|---|---|
| William L Mack |
Corporate Officer | Jan 1, 2025 | |
| Margaret M Crotty |
Corporate Officer | Jan 1, 2025 | |
| Northwell, Inc. |
5% Or Greater Indirect Ownership Interest | Jul 1, 2024 | |
| Harry E Gindi |
Corporate Officer | Jan 1, 2025 | |
| Jeffrey a Kraut |
Corporate Officer | Jan 1, 2025 | |
| Robert D Rosenthal |
Corporate Officer | Jan 1, 2025 | |
| Mark L Claster |
Corporate Officer | Jan 1, 2025 | |
| Brian Lally |
Corporate Officer | Jan 1, 2025 | |
| Mark J Solazzo |
Corporate Officer | Jan 1, 2025 | |
| Richard D Goldstein |
Corporate Officer | Jan 1, 2025 | |
| Northwell Healthcare Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2015 | 100% |
| David L Battinelli |
Corporate Officer | Jan 1, 2025 | |
| Donald Zucker |
Corporate Officer | Jan 1, 2025 | |
| Barry Rubenstein |
Corporate Officer | Jan 1, 2025 | |
| Northwell Health Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2015 | |
| Michael a Epstein |
Corporate Officer | Jan 1, 2025 | |
| Mark a. Gloade |
Corporate Officer | Jan 1, 2025 | |
| John K D'Angelo |
Corporate Officer | Jan 1, 2025 | |
| Donna K Drummond |
Corporate Officer | Jan 1, 2025 | |
| Michael J Dowling |
Corporate Officer | Jan 1, 2025 | |
| Laurence a Kraemer |
Corporate Officer | Jan 1, 2025 | |
| Konstantine Costalas |
Corporate Officer | Jan 1, 2025 | |
| Ralph a Nappi |
Corporate Officer | Jan 1, 2025 | |
| Kevin Beiner |
Corporate Officer | Jan 1, 2025 | |
| Michele L Cusack |
Corporate Officer | Sep 12, 2017 | |
| W-2 Managing Employee | Sep 12, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060914000038 | NY | Part a Provider - Hospital | 4981508082 | Practice locations: Riverhead, NY |
National Provider Directory
- Tax ID family
- Central Suffolk Hosp P
Locations
40 Sunset Ridge Rd
New Paltz, NY 12561
Phone (845) 255-6023
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| General Acute Care Hospital | 282N00000X | 5155000H | NY | Yes |
Addresses
Primary practice location
1300 Roanoke Ave
Riverhead, NY 11901-2031
Mailing address
1300 Roanoke Ave
Riverhead, NY 11901-2031
Phone (631) 548-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007461 | Other | NY | AETNA US HEALTHCARE |
| 03000300 | Medicaid | NY | |
| 5225-7 | Other | NY | BC DIALYSIS |
| 000250-7 | Other | NY | BLUE CROSS |
| 00274328 | Medicaid | NY | |
| H03149 | Other | NY | OXFORD |
Other names
- Peconic Bay Medical Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://fhir-myrecord.cerner.com/dstu2 | Health Information Exchange (HIE) | |
| CONNECT URL | https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark |
| Direct Messaging Address | direct@direct.toc.pbmchealth.org | Health Information Exchange (HIE) |
Other providers in Riverhead, NY
- Cea Speech-Language Pathology, PLLC
- Veronica Cea
- Alexis Marie Celentano
- Central Suffolk Hospital
- Central Suffolk Hospital
- Central Suffolk Hospital
- Central Suffolk Hospital
- Central Suffolk Hosptial
- Julian Cereghini
- Sara Ann Cerrone
All providers in Riverhead, NY · General Acute Care Hospital in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.