Brookhaven Heart PLLC
Organization Active NPI Cardiovascular Disease Physician · Patchogue, NY
NPI 1639260607 · NPPES record last updated Nov 7, 2022
Key facts
- NPI
- 1639260607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 222332 (NY)
- Legal business name
- BROOKHAVEN HEART PLLC
- Practice address
- 325 E Main St Ste 120
Patchogue, NY 11772-3114 - Phone
- (631) 654-3278
- Fax
- (631) 654-1474
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Satheesh Joseph, MD
- Title
- President
- Phone
- (631) 654-3278
Practitioners 44
-
Deepu Koshy Alexander, M.D.
-
Marc Cimmino, D.O.
-
Troy E Dickinson, DO
-
Fazal G Faroqui, DO
-
Satheesh Joseph, M.D.
-
Adam Kruger, D.O.
-
Krystie Leigh Manaro, FNP
-
Kumar S Mandal, M.D.
-
Jacob K Mathew, MD
-
Kristen Monteiro, RN
-
Bimal Patel, MD
-
Saurin Ramabhai Patel, M.D.
-
Annamaria Pepitone, FNP-C
-
Wasiq Rahman, MD
-
Afsoon Razavi, MD
-
Christopher Ptak, PA-C
-
Jennifer Lynn Steinberg, RPAC
-
Kimberly Patrice Barnaby, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D1060148 | Brookhaven Heart PLLC | Certificate of waiver | Oct 16, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061229000335 | NY | Part B Supplier - Clinic/Group Practice | 6305846114 |
Receives reassigned benefits from 41 practitioners Practice locations: Patchogue, NY |
National Provider Directory
Locations
325 E Main St
Ste 120
Patchogue, NY 11772
Phone (631) 654-3278
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EEFCAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 222332 | NY | |
| Cardiovascular Disease Physician |
207RC0000X | 222332 | NY | Yes |
| Magnetic Resonance Imaging (MRI) Internal Medicine Physician |
207RM1200X | 222332 | NY | |
| Nuclear Cardiology Physician |
207UN0901X | 222332 | NY |
Addresses
Primary practice location
325 E Main St Ste 120
Patchogue, NY 11772-3114
Mailing address
325 E Main St Ste 120
Patchogue, NY 11772-3114
Phone (631) 654-3278
Other practice location 1
100 Hospital Rd Ste 120
East Patchogue, NY 11772-4821
Phone (631) 654-3278
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jshea@brookhavenheart.com |
Other providers in Patchogue, NY
- Allyson Brodsky-Matwey
- Brookhaven Anesthesia Associates
- Brookhaven Anesthesia Associates, LLP
- Brookhaven Cardiac LLC
- Brookhaven Family Medicine
- Brookhaven Mem Hosp-Nuc C
- Brookhaven Memorial Hosp Psych
- Brookhaven Memorial Hospital
- Brookhaven Memorial Hospital
- Brookhaven Memorial Hospital Medical Center
All providers in Patchogue, NY · Cardiovascular Disease Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.