Organization Active NPI

Shore OB GYN, P.C.

  • Obstetrics & Gynecology Physician
  • Bay Shore, NY
National Provider Identifier
1528396892
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
182878 Issued in NY
Legal business name
SHORE OB GYN, P.C.
Practice address
69 West Main St.
Bay Shore, NY 11706-8313
Phone
(631) 665-4044
Fax
(631) 665-3928
NPI assigned
Nov 25, 2009
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Dr. Mark Thomas Foehr, M.D.NPI 1144307299
Title
Physician
Phone
(631) 665-4044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 182878 NY Primary

Addresses

Primary practice location

69 West Main St.
Bay Shore, NY 11706-8313

Mailing address

69 West Main St.
Bay Shore, NY 11706-8313
Phone (631) 665-4044

Other identifiers 1

IdentifierTypeStateIssuer
01569295MedicaidNY

National Provider Directory

National Provider Directory

Locations

69 W Main St
Bay Shore, NY 11706
Phone (631) 665-4044

Practitioners & affiliated clinicians

Practitioners 1

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": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1528396892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 WEST MAIN ST.",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068313",
            "telephone_number": "631-665-4044",
            "fax_number": "631-665-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 WEST MAIN ST.",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068313",
            "telephone_number": "631-665-4044",
            "fax_number": "631-665-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE OB GYN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "FOEHR",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-665-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "182878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01569295",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.