NPIMap

Organization Active NPI

CHS Physician Partners, PC

Doing business as Gupta Medical Practice

  • Internal Medicine Physician
  • Merrick, NY
National Provider Identifier
1619315975
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHS PHYSICIAN PARTNERS, PC
Doing business as
Gupta Medical Practice
Practice address
1703 Merrick Ave
Merrick, NY 11566-1628
Phone
(516) 378-3311
Fax
(516) 546-1517
NPI assigned
Jun 10, 2013
Last updated
Jul 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CHS PHYSICIAN PARTNERS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Dr. Jack Soterakis, MD
Title
President
Phone
(516) 562-6231

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Gastroenterology Physician 207RG0100X NU
Nuclear Cardiology Physician 207UN0901X NU

Addresses

Primary practice location

1703 Merrick Ave
Merrick, NY 11566-1628

Mailing address

PO Box 95000-6625
Philadelphia, PA 19195-6625
Phone (631) 465-6297

Other names 1

  • Gupta Medical Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708000027 NY Part B Supplier - Clinic/Group Practice 7618955667 Receives reassigned benefits from 1,098 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Part of
Sungwai Chiu MD

Practitioners & affiliated clinicians

Practitioners 2

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": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1619315975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-6625",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191956625",
            "telephone_number": "631-465-6297",
            "fax_number": "631-465-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MERRICK AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661628",
            "telephone_number": "516-378-3311",
            "fax_number": "516-546-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHYSICIAN PARTNERS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS PHYSICIAN PARTNERS, PC",
        "enumeration_date": "2013-06-10",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SOTERAKIS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-562-6231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gupta Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gupta Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.