NPIMap

Organization Active NPI

NYU Langone Hospitals

Doing business as Brookhaven Memorial Hospital Hospice

  • Community Based Hospice Care Agency
  • Patchogue, NY
National Provider Identifier
1609877364
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
5151500F Issued in NY
Legal business name
NYU LANGONE HOSPITALS
Doing business as
Brookhaven Memorial Hospital Hospice
Long Island Community Hospital
NYU Langone Hospital - Suffolk
Practice address
105 West Main Street
Patchogue, NY 11772-3003
Phone
(631) 687-2960
Fax
(631) 687-2970
NPI assigned
Aug 3, 2005
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 Adlerq
Title
Sr VP-Chief of Hospital Operations
Phone
(631) 654-7177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 5151500F NY Primary

Addresses

Primary practice location

105 West Main Street
Patchogue, NY 11772-3003

Mailing address

105 West Main Street
Patchogue, NY 11772-3003
Phone (631) 687-2960

Other identifiers 2

IdentifierTypeStateIssuer
004419OtherNYBLUE CROSS
01143186MedicaidNY

Other names 3

  • Brookhaven Memorial Hospital Hospice Doing business as
  • 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
O20250421001736 NY Part A Provider - Hospice 4981515699 Practice locations: Patchogue, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609877364. Details of each certification follow.

Hospice certification: CCN 331537

Legal name
NYU LANGONE HOSPITALS
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 27, 1989
Last certification
Feb 12, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Enrollment address
105 W Main St
Patchogue, NY 11772-3003

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: Hospice

Medicare Care Compare
Listed as
NYU Langone Hospital - Suffolk HospiceCCN 331537 · All quality measures
Ownership
Non-Profit
Certified
Sep 27, 1989
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Hospital for Joint Diseases NYU Lagone Medical Center64 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

Locations

105 W Main St
Patchogue, NY 11772
Phone (631) 687-2960

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Annette Johnson Individual Corporate Officer Mar 1, 2025
Nancy Sanchez Individual Corporate Officer Mar 1, 2025
Fritz Francois Individual Corporate Officer Mar 1, 2025
Grace Y Ko Individual Corporate Officer Mar 1, 2025
Dafna Bar-Sagi Individual Corporate Officer Mar 1, 2025
Bret J. Rudy Individual Corporate Officer Mar 1, 2025
Elizabeth Golden Individual Corporate Officer Mar 1, 2025
Robert I Grossman Individual Corporate Officer Mar 1, 2025
W-2 Managing EmployeeAd; Mar 1, 2025
NYU Langone Health System Organization, New York, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2015
Nader Mherabi Individual Corporate Officer Mar 1, 2025
Joseph J Lhota Individual Corporate Officer Mar 1, 2025
W-2 Managing Employee Mar 1, 2025
Steven B Abramson Individual Corporate Officer Mar 1, 2025
Joseph J Greco Individual Corporate Officer Mar 1, 2025
Andrew W Brotman Individual Corporate Officer Mar 1, 2025
W-2 Managing EmployeeMD; Mar 1, 2025
Vicki Match Suna Individual Corporate Officer Mar 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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.

Affiliated clinicians 5

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": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1609877364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEST MAIN STREET",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723003",
            "telephone_number": "631-687-2960",
            "fax_number": "631-687-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEST MAIN STREET",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723003",
            "telephone_number": "631-687-2960",
            "fax_number": "631-687-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYU LANGONE HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "ADLERQ",
        "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NY",
            "license": "5151500F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "004419",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01143186",
            "state": "NY"
        }
    ],
    "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": "Brookhaven Memorial Hospital Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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

Verify at the official NPI Registry.