Organization Active NPI

North Shore Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
National Provider Identifier
1396794574
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC
Practice address
49 Nesconset Hwy
Port Jefferson Station, NY 11776
Phone
(631) 751-3000
Fax
(631) 509-6559
NPI assigned
May 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
Patricia Dandraia
Title
Credentialing Coordinator
Phone
(631) 751-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

49 Nesconset Hwy
Port Jefferson Station, NY 11776

Mailing address

1 Research Rd
Ridge, NY 11961-2701
Phone (163) 175-1300

Other identifiers 2

IdentifierTypeStateIssuer
00679947MedicaidNY
CC5178OtherNYRR MEDICARE

Practitioners 767

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040324001766 NY Part B Supplier - Clinic/Group Practice 1456243641 Receives reassigned benefits from 737 practitioners
O20100930045948 NY DME Supplier - Physician - Hematology/OncologyDME Supplier - Multi-Specialty - Physician 1456243641 Practice locations: Port Jefferson Station, NY

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations (25 of 92)

2747 Crescent St
Ste 107A
Astoria, NY 11102

2322 30th Rd
Ste 1A
Astoria, NY 11102
Phone (667) 326-9198

2360 Grand Ave
Baldwin, NY 11510
Phone (516) 459-6570

72 E Main St
Bay Shore, NY 11706

375 E Main St
Ste 5
Bay Shore, NY 11706

69 W Main St
Ste 1
Bay Shore, NY 11706

4564 Francis Lewis Blvd
Ste 20
Bayside, NY 11361

2330 Eastchester Rd
#2
Bronx, NY 10469

1749 Grand Concourse
Ofc A
Bronx, NY 10453
Phone (718) 975-3342

1983 Dr Martin L King Jr Blvd
Bronx, NY 10453
Phone (718) 299-5446

2035 Ralph Ave
Ste C
Brooklyn, NY 11234
Phone (718) 968-2059

175 Remsen Ave
Brooklyn, NY 11212

175 Remsen St
Ste 1225
Brooklyn, NY 11201
Phone (718) 222-2600

175 Remsen Ave
Ste 1225
Brooklyn, NY 11212

175 Remsen St
Fl 12
Brooklyn, NY 11201

172 Myrtle Ave
Brooklyn, NY 11201

2201 Route 112
Coram, NY 11727

32645 Main Rd
Ste 78
Cutchogue, NY 11935

32645 Main Rd
Ste 7
Cutchogue, NY 11935

41 Bay Ave
East Moriches, NY 11940
Phone (631) 727-4171

285 Sills Rd
Bldg F
East Patchogue, NY 11772

285 Sills Rd
Bldg 1
East Patchogue, NY 11772
Phone (631) 654-8200

226 N Belle Mead Rd
East Setauket, NY 11733
Phone (631) 675-0568

7 S Jersey Ave
Ste 1S
East Setauket, NY 11733

9009 Queens Blvd
Elmhurst, NY 11373

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1396794574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RESEARCH RD",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119612701",
            "telephone_number": "163-175-1300",
            "fax_number": "631-509-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-751-3000",
            "fax_number": "631-509-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "DANDRAIA",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "631-751-3000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00679947",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC5178",
            "state": "NY"
        }
    ],
    "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 Mar 16, 2023; 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.