Southside Hospital Faculty Practice

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHSIDE HOSPITAL FACULTY PRACTICE

Practice address

301 E Main St
Bay Shore, NY 11706-8408

Phone

(631) 675-4149

NPI assigned

Apr 26, 2006

Organization subpart

Yes

Parent organization

SOUTHSIDE HOSPITALAs reported in NPPES

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

Authorized official

Name

Ms. Winifred Mack

Title

Cfo

Phone

(631) 968-9000

Specialties & licenses 6

Addresses

Other identifiers 1

Part of

Southside Hospital HHA

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael A Masciello, MD

  • Cardiovascular Disease Physician
  • West Islip, NY
  • NPI 1306824719
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1619934544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-675-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-675-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE HOSPITAL FACULTY PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE HOSPITAL",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "WINIFRED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-968-9000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167655",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southside Hospital Department of Cardiology
• Southside Hospital Department of Neurology
• Southside Hospital Department of Pathology
• Southside Hospital Department of Psychiatry
• Southside Hospital Emergency Department
• Jaclyn Spiegel, PSY.D.
• Rex Spielmann, MD
• Richard Frank Spinello
• Peter Alex Spiratos
• Joanne St.Robert

• Internal Medicine Physician in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.