NPIMap

Individual provider Active NPI

Christine M Fruth Giacobbe, D.O.

  • Internal Medicine Physician
  • Port Jefferson Station, NY
National Provider Identifier
1417920208
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2314361 Issued in NY
Practice address
9 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1591
Phone
(631) 473-3900
Fax
(631) 474-4475
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2314361 NY Primary

Addresses

Primary practice location

9 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1591

Mailing address

9 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1591
Phone (631) 473-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001097 NY Practitioner - Internal Medicine 2961392543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbor View Medical Services PCGroup PAC ID 5092865873, shared by 3 NPIs, 58 clinicians

Practice addresses (Care Compare)

1500 Route 112
Suite a
Port Jefferson Station, NY 11776-8055
Phone (631) 476-2721

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2314361NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor View Medical Services PC Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Harbor View Medical Services PC Current Accepting new patients
Harbor View Medical Services PC Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
North Shore Internal Medicine, PC Internal Medicine Past Accepting new patients

Locations

1500 Route 112
Ste A
Port Jefferson Station, NY 11776
Phone (631) 331-1120

9 Medical Dr
Ste B
Port Jefferson Station, NY 11776
Phone (631) 473-3900

1500 Route 112
Bldg 6A
Port Jefferson Station, NY 11776
Phone (631) 476-2721

625 Belle Terre Rd
Ste 100
Prt Jefferson, NY 11777
Phone (631) 686-7603

70 N Country Rd
Ste 101
Prt Jefferson, NY 11777
Phone (631) 473-0037

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2858/brand/1/csg/1/fhir/r4
  • Direct secure messaging: christine.fruth.giacobbe.1@8551.direct.athenahealth.com

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1417920208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761591",
            "telephone_number": "631-473-3900",
            "fax_number": "631-474-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761591",
            "telephone_number": "631-473-3900",
            "fax_number": "631-474-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUTH GIACOBBE",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "2314361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.