Organization Active NPI

Brookhaven Gastroenterology Associates, P.C.

  • Gastroenterology Physician
  • E Patchogue, NY
National Provider Identifier
1447456652
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BROOKHAVEN GASTROENTEROLOGY ASSOCIATES, P.C.
Practice address
260 Patchogue Yaphank Rd
Suite C
E Patchogue, NY 11772-4886
Phone
(631) 289-0300
Fax
(631) 289-0402
NPI assigned
Jun 25, 2007
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Authorized official

Name
Dr. Ravi P Singh, MDNPI 1508880774
Title
President
Phone
(631) 289-2716

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

260 Patchogue Yaphank Rd
Suite C
E Patchogue, NY 11772-4886

Mailing address

260 Patchogue Yaphank Rd
Suite C
E Patchogue, NY 11772-4886
Phone (631) 289-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000279 NY Part B Supplier - Clinic/Group Practice 3274437272 Receives reassigned benefits from 20 practitioners
Practice locations: East Patchogue, NY; Port Jefferson, NY; Westhampton Beach, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2265192Brookhaven Gastroenterology Associates PC260 Patchogue-Yaphank Road Suite D, East Patchogue, NY 11772Certificate of waiverJul 24, 2028

National Provider Directory

National Provider Directory

Locations

260 Patchogue Yaphank Rd
Ste D
East Patchogue, NY 11772

620 Belle Terre Rd
Ste 4
Prt Jefferson, NY 11777
Phone (631) 289-1708

365 County Road 39A
Unit 8
Southampton, NY 11968
Phone (631) 287-1566

10 Old Riverhead Rd
Westhampton Beach, NY 11978
Phone (631) 369-4292

10 Old Riverhead Rd
Unit D
Westhampton Beach, NY 11978
Phone (631) 289-5101

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFBACA

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1447456652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE C",
            "city": "E PATCHOGUE",
            "state": "NY",
            "postal_code": "117724886",
            "telephone_number": "631-289-0300",
            "fax_number": "631-289-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE C",
            "city": "E PATCHOGUE",
            "state": "NY",
            "postal_code": "117724886",
            "telephone_number": "631-289-0300",
            "fax_number": "631-289-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN GASTROENTEROLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-289-2716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in E Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.