NPIMap

Individual provider Active NPI

Polly Kanganis, M.D.

  • Obstetrics & Gynecology Physician
  • Smithtown, NY
National Provider Identifier
1477644698
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
194602 Issued in NY
Practice address
200 E Main St Ste 1E
Smithtown, NY 11787-2812
Phone
(631) 265-4567
Fax
(631) 265-4704
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 194602 NY Primary

Addresses

Primary practice location

200 E Main St Ste 1E
Smithtown, NY 11787-2812

Mailing address

45 Research Way Ste 208a
East Setauket, NY 11733-6401
Phone (631) 675-2175

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
I20110406000899 NY Practitioner - Obstetrics/Gynecology 2062696529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Columbia University College of Physicians and Surgeons, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 E Main St
Smithtown, NY 11787-2878
Phone (631) 265-4567

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
194602NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Sep 1, 2012 Accepting new patients
Boston Children'S Health Physicians, LLP Obstetrics & Gynecology CurrentSince Sep 1, 2012 Accepting new patients
University Associates in Obstetrics & Gynecology, University Faculty P Obstetrics & Gynecology CurrentSince Sep 1, 2019 Accepting new patients
Jefferson Medical Surgery PC PastSince Aug 25, 2019 Accepting new patients

Locations

4 Studio Arc
Bronxville, NY 10708
Phone (914) 337-2022

130 Pondfield Rd
Bronxville, NY 10708
Phone (914) 337-4224

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

309 E Middle Country Rd
Ste 101
Smithtown, NY 11787
Phone (631) 265-4567

200 E Main St
Smithtown, NY 11787
Phone (631) 265-2580

200 E Main St
Ste 1E
Smithtown, NY 11787
Phone (631) 265-4567

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: polly.kanganis@sbcm.cernerdirect.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 8

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1477644698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 208A",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-675-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST STE 1E",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872812",
            "telephone_number": "631-265-4567",
            "fax_number": "631-265-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANGANIS",
        "first_name": "POLLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "194602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.