Organization Active NPI

Long Island Child Psychiatry, PLLC

  • Psychiatry Physician
  • East Setauket, NY
National Provider Identifier
1568880771
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
248588 Issued in NY
Legal business name
LONG ISLAND CHILD PSYCHIATRY, PLLC
Practice address
100 S Jersey Ave
Unit #1
East Setauket, NY 11733-2034
Phone
(631) 343-3140
Fax
(631) 343-3124
NPI assigned
Apr 3, 2014
Last updated
Apr 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Dr. James Townsend, D.O.NPI 1497973226
Title
Managing Member
Phone
(631) 343-3140

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 248588 NY Primary

Addresses

Primary practice location

100 S Jersey Ave
Unit #1
East Setauket, NY 11733-2034

Mailing address

100 S Jersey Ave
Unit #1
East Setauket, NY 11733-2034
Phone (631) 343-3140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140730002870 NY Part B Supplier - Clinic/Group Practice 0143446989 Receives reassigned benefits from 1 practitioner
Practice locations: East Setauket, NY

National Provider Directory

National Provider Directory

Locations

100 S Jersey Ave
Unit 1
East Setauket, NY 11733
Phone (631) 343-3140

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": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1568880771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE",
            "address_2": "UNIT #1",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332034",
            "telephone_number": "631-343-3140",
            "fax_number": "631-343-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE",
            "address_2": "UNIT #1",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332034",
            "telephone_number": "631-343-3140",
            "fax_number": "631-343-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND CHILD PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "631-343-3140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "248588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.