Individual provider Active NPI

William Joseph Sellers, D.O.

  • Surgery Physician
  • Port Jefferson, NY
National Provider Identifier
1437411428
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
300982 Issued in NY
Practice address
70 N Country Rd Ste 203
Port Jefferson, NY 11777-2161
Phone
(631) 474-0707
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 300982 NY Primary

Addresses

Primary practice location

70 N Country Rd Ste 203
Port Jefferson, NY 11777-2161

Mailing address

70 N Country Rd Ste 203
Port Jefferson, NY 11777-2161
Phone (631) 474-0707

Other practice location 1

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone (570) 808-7300

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
I20190930000167 NY Practitioner - Colorectal Surgery (Proctology) 6901102870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

500 Commack Rd
Unit 150
Commack, NY 11725-5009
Phone (631) 689-6698

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300982NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Physician Associates, PLLC Surgery CurrentSince Sep 1, 2019 Accepting new patients
CHS Physician Partners, P.C CurrentSince Oct 3, 2022 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
St Charles Hospital Corp Past Accepting new patients

Locations

2112 Middle Country Rd
Centereach, NY 11720
Phone (631) 247-7463

500 Commack Rd
Unit 150
Commack, NY 11725
Phone (631) 371-8034

500 Commack Rd
Unit 150B
Commack, NY 11725
Phone (516) 627-8717

70 N Country Rd
Ste 203
Prt Jefferson, NY 11777
Phone (631) 744-3611

200 Belle Terre Rd
Ste 300
Prt Jefferson, NY 11777
Phone (631) 331-0776

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

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

Interoperability endpoints

  • Direct secure messaging: wsellers118950@direct-chsli.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1437411428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD STE 203",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-474-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD STE 203",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-474-0707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Mountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187110027",
            "country_code": "US",
            "telephone_number": "570-808-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "300982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.