NPIMap

Organization Active NPI

Mathew T. Chengot MD PC

  • Specialist
  • Amityville, NY
National Provider Identifier
1467670661
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
148679 Issued in NY
Legal business name
MATHEW T. CHENGOT MD PC
Practice address
129 Broadway
Amityville, NY 11701-2729
Phone
(631) 598-3434
Fax
(631) 598-4723
NPI assigned
Apr 23, 2007
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Dr. Mathew Thomas Chengot, M.D.NPI 1831147511
Title
President
Phone
(631) 598-3434

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
Specialist 174400000X 148679 NY Primary

Addresses

Primary practice location

129 Broadway
Amityville, NY 11701-2729

Mailing address

129 Broadway
Amityville, NY 11701-2729
Phone (631) 598-3434

Other identifiers 5

IdentifierTypeStateIssuer
00826077MedicaidNY
02585784MedicaidNY
0133135MedicaidNY
01760172MedicaidNY
01762716MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000493 NY Part B Supplier - Clinic/Group Practice 5092740597 Receives reassigned benefits from 6 practitioners
Practice locations: Amityville, NY

National Provider Directory

National Provider Directory

Locations

129 Broadway
Amityville, NY 11701
Phone (516) 626-5330

389 Broadway
Amityville, NY 11701
Phone (631) 789-3434

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71355

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1467670661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012729",
            "telephone_number": "631-598-3434",
            "fax_number": "631-598-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012729",
            "telephone_number": "631-598-3434",
            "fax_number": "631-598-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHEW T. CHENGOT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "CHENGOT",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-598-3434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "148679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00826077",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02585784",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133135",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01760172",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01762716",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.