NPIMap

Organization Active NPI

Island Home Care Agency, Inc

  • Nursing Care Agency
  • Hauppauge, NY
National Provider Identifier
1417263153
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
1578L001 Issued in NY
Legal business name
ISLAND HOME CARE AGENCY, INC
Practice address
175 Commerce Dr Ste D
Hauppauge, NY 11788-3920
Phone
(631) 289-6223
Fax
(631) 289-7473
NPI assigned
Aug 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Authorized official

Name
Susan Fechtmann
Title
Vice President/Administrator
Phone
(631) 289-6223

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1578L001 NY
Nursing Care Agency 251J00000X 1578L001 NY Primary

Addresses

Primary practice location

175 Commerce Dr Ste D
Hauppauge, NY 11788-3920

Mailing address

175 Commerce Dr Ste D
Hauppauge, NY 11788-3920
Phone (631) 289-6223

Other identifiers 1

IdentifierTypeStateIssuer
S065BOtherNYEBCBS

National Provider Directory

National Provider Directory
Tax ID family
Island Home Care Agency Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1417263153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 COMMERCE DR STE D",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883920",
            "telephone_number": "631-289-6223",
            "fax_number": "631-289-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 COMMERCE DR STE D",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883920",
            "telephone_number": "631-289-6223",
            "fax_number": "631-289-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND HOME CARE AGENCY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "FECHTMANN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "VICE PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "631-289-6223"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "1578L001",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "1578L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EBCBS",
            "identifier": "S065B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.