NPIMap

Organization Active NPI

NYU Langone Hospitals

Doing business as Long Island Community Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Patchogue, NY
National Provider Identifier
1487743480
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NYU LANGONE HOSPITALS
Doing business as
Long Island Community Hospital
NYU Langone Hospital - Suffolk
Practice address
109 West Main Street
Patchogue, NY 11772-3003
Phone
(631) 687-2828
Fax
(631) 687-2879
NPI assigned
Oct 11, 2006
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Dr. Marc Adler
Title
Sr. VP-Chief of Hospital Operations
Phone
(631) 654-7177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

109 West Main Street
Patchogue, NY 11772-3003

Mailing address

101 Hospital Road
Patchogue, NY 11772-4870
Phone (631) 654-7100

Other names 2

  • Long Island Community Hospital Doing business as
  • NYU Langone Hospital - Suffolk Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250312003219 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 4981515699 Practice locations: Patchogue, NY

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Long Island Community Hospital - West Main StCCN 333527
Overall star rating
2.0 of 5
Ownership
Non-profit
Certified
Jul 27, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
24

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

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
33D1075731NYU Langone Hospital - Suffolk109 W Main St, Patchogue, NY 11772Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
NYU Langone Hospitals64 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1487743480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL ROAD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-654-7100",
            "fax_number": "631-654-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WEST MAIN STREET",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723003",
            "telephone_number": "631-687-2828",
            "fax_number": "631-687-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYU LANGONE HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "ADLER",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "SR. VP-CHIEF OF HOSPITAL OPERATIONS",
        "authorized_official_telephone_number": "631-654-7177",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Long Island Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NYU Langone Hospital - Suffolk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.