NPIMap

Organization Active NPI

St Charles Hospital Corp

  • General Acute Care Hospital
  • Port Jefferson, NY
National Provider Identifier
1497765630
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ST CHARLES HOSPITAL CORP
Practice address
200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone
(631) 474-6000
NPI assigned
Aug 9, 2006
Reactivated
Jun 11, 2013
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Lorraine Hummel, DIRECTOR
Title
Director
Phone
(631) 465-6225

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NY
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

Mailing address

PO Box 95000-6655
Philadelphia, PA 19195-0001
Phone (631) 465-6121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, NJ, NC, PA5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20050205000015 NY Part B Supplier - Clinic/Group Practice 6103733050 Receives reassigned benefits from 223 practitioners
Practice locations: Centereach, NY; Melville, NY; Port Jefferson, NY
O20250605003960 FL Part B Supplier - Clinic/Group Practice 6103733050 Receives reassigned benefits from 8 practitioners
Practice locations: North Fort Myers, FL; Weston, FL; Vero Beach, FL; Tampa, FL; Stuart, FL; Melbourne, FL; Ellenton, FL
O20250830000711 NJ Part B Supplier - Clinic/Group Practice 6103733050 Receives reassigned benefits from 5 practitioners
Practice locations: Freehold, NJ; Paramus, NJ; Mahwah, NJ; Madison, NJ; Cranbury, NJ
O20251203001386 NC Part B Supplier - Clinic/Group Practice 6103733050 Receives reassigned benefits from 6 practitioners
Practice locations: Asheville, NC; Concord, NC; Durham, NC; Holly Springs, NC; Raleigh, NC; Winston Salem, NC
O20251209003306 PA Part B Supplier - Clinic/Group Practice 6103733050 Receives reassigned benefits from 2 practitioners
Practice locations: Latrobe, PA; Wexford, PA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

2100 Middle Country Rd
Centereach, NY 11720
Phone (631) 580-2526

Practitioners & affiliated clinicians

Practitioners 242

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 242

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1497765630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-6655",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001",
            "telephone_number": "631-465-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771928",
            "telephone_number": "631-474-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES HOSPITAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "deactivation_date": "2011-04-08",
        "reactivation_date": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "HUMMEL",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-465-6225",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "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 May 28, 2026; 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.