NPIMap

Organization Active NPI

John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
National Provider Identifier
1467249334
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
JOHN T. MATHER MEMORIAL HOSPITAL
Practice address
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone
(631) 473-1320
Fax
(631) 686-7972
NPI assigned
Apr 23, 2025
Last updated
Apr 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Christine Livreri
Title
Avp
Phone
(631) 473-1320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X Primary

Addresses

Primary practice location

75 N Country Rd
Port Jefferson, NY 11777-2119

Mailing address

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

Other practice location 1

70 N Country Rd Ste 302
Port Jefferson, NY 11777-2161
Phone (631) 473-1320

Other practice location 2

5225 Nesconset Hwy
Port Jefferson Station, NY 11776-2053
Phone (631) 473-1320

Other practice location 3

500 Commack Rd Bldg E
Suite 150D
Commack, NY 11725-5020
Phone (631) 473-1320

Other practice location 4

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 473-1320

Other practice location 5

625 Belle Terre Rd Ste 204
Port Jefferson, NY 11777-2318
Phone (631) 473-1320

Other practice location 6

125 Oakland Ave Ste 301
Port Jefferson, NY 11777-2130
Phone (631) 473-1320

Other practice location 7

170 N Country Rd Ste 3
Port Jefferson, NY 11777-2606
Phone (631) 473-1320

Other practice location 8

70 N Country Rd Ste 205
Port Jefferson, NY 11777-2161
Phone (631) 473-1320

Other practice location 9

625 Belle Terre Rd Ste 113
Port Jefferson, NY 11777-2316
Phone (631) 473-1320

Other practice location 10

100 Highlands Blvd Ste 303
Port Jefferson, NY 11777-2320
Phone (631) 473-1320

Other practice location 11

125 Oakland Ave Ste 303
Port Jefferson, NY 11777-2130
Phone (631) 473-1320

Other practice location 12

100 Highlands Blvd Ste 101
Port Jefferson, NY 11777-2320
Phone (631) 473-1320

Other practice location 13

100 Highlands Blvd Ste 201
Port Jefferson, NY 11777-2320
Phone (631) 473-1320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250701003602 NY Part B Supplier - Clinic/Group Practice 1254237753 Receives reassigned benefits from 304 practitioners
Practice locations: Port Jefferson Station, NY; Port Jefferson, NY; Commack, NY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

500 Commack Rd
Bldg E
Commack, NY 11725
Phone (631) 689-0220

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

5505 Nesconset Hwy
Ste 238
Mount Sinai, NY 11766
Phone (631) 428-3122

100 Highlands Blvd
Ste 101
Port Jefferson, NY 11777
Phone (631) 331-8200

100 Highlands Blvd
Ste 201
Port Jefferson, NY 11777
Phone (631) 473-3877

120 N Country Rd
Ste 3
Port Jefferson, NY 11777
Phone (631) 928-3122

125 Oakland Ave
Port Jefferson, NY 11777
Phone (631) 476-2737

625 Belle Terre Rd
Ste 113
Port Jefferson, NY 11777
Phone (631) 476-2721

625 Belle Terre Rd
Ste 204
Port Jefferson, NY 11777
Phone (631) 689-0220

75 N Country Rd
#1002
Port Jefferson, NY 11777
Phone (631) 476-2767

625 Belle Terre Rd
Ste 203
Prt Jefferson, NY 11777
Phone (631) 686-7897

75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575

Practitioners & affiliated clinicians

Practitioners 388

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 388

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1467249334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 N Country Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772161",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5225 Nesconset Hwy",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson Station",
            "state": "NY",
            "postal_code": "117762053",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Commack Rd Bldg E",
            "address_2": "Suite 150D",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117255020",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 Belle Terre Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772318",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Oakland Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772130",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 N Country Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772606",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 N Country Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772161",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 Belle Terre Rd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772316",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highlands Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772320",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Oakland Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772130",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highlands Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772320",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highlands Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772320",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN T. MATHER MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "LIVRERI",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "631-473-1320"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.