Individual provider Active NPI

Kathleen Harris Scarbrough, MD

  • Public Health & General Preventive Medicine Physician
  • Setauket, NY
National Provider Identifier
1417057308
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
244603 Issued in NY
Practice address
181 N Belle Mead Rd Ste 2
Setauket, NY 11733-3495
Phone
(631) 444-6250
Fax
(631) 444-6665
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 244603-1 NY
Public Health & General Preventive Medicine Physician 2083P0901X 244603 NY Primary

Addresses

Primary practice location

181 N Belle Mead Rd Ste 2
Setauket, NY 11733-3495

Mailing address

16 Gabriel Mills Rd Ste 3
Wading River, NY 11792-1506
Phone (631) 655-2516

Other identifiers 1

IdentifierTypeStateIssuer
001407974MedicaidCT

Other names 1

  • Kathleen Harris Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000493 NY Practitioner - Preventive MedicinePractitioner - Obstetrics/Gynecology 7113067133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Georgetown University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
244603-1NYMDGynecology Physician
244603NYMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Family and Preventive Medicine, University Faculty Practic CurrentSince Jul 15, 2021 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
East End Womens Health Care P.C. PastSince Sep 1, 2003 Accepting new patients
Square Care Medical Group, LLP Past Accepting new patients

Locations

4 Smith Haven Mall
Ste 202
Lake Grove, NY 11755
Phone (631) 444-5858

181 N Belle Mead Rd
Ste 2
Setauket, NY 11733
Phone (631) 444-5858

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: kathleen.scarbrough@direct.stonybrookmedicine.edu
  • FHIR API: https://api.platform.athenahealth.com/15987/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1417057308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GABRIEL MILLS RD STE 3",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117921506",
            "telephone_number": "631-655-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N BELLE MEAD RD STE 2",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117333495",
            "telephone_number": "631-444-6250",
            "fax_number": "631-444-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBROUGH",
        "first_name": "KATHLEEN",
        "middle_name": "HARRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "244603-1",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NY",
            "license": "244603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001407974",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "HARRIS",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Setauket, NY

Sources for this page

Verify at the official NPI Registry.