NPIMap

Organization Active NPI

University Hospital at Stony Brook

  • Psychiatric Hospital Unit
  • Stony Brook, NY
National Provider Identifier
1649294026
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
5151001H Issued in NY
Legal business name
UNIVERSITY HOSPITAL AT STONY BROOK
Practice address
Nicolls Rd
Stony Brook, NY 11794-9112
Phone
(631) 444-4100
Fax
(631) 444-4082
NPI assigned
Jul 27, 2006
Last updated
Nov 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Authorized official

Name
Mr. Gary E Bie
Title
Chief Financial Officer
Phone
(631) 444-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 5151001H NY Primary

Addresses

Primary practice location

Nicolls Rd
Stony Brook, NY 11794-9112

Mailing address

Nicolls Rd
Stony Brook, NY 11794-9112
Phone (631) 444-4100

Other identifiers 1

IdentifierTypeStateIssuer
00357795MedicaidNY

Other names 1

  • Stony Brook University Hospital Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120802000036 NY Part A Provider - Hospital 2365341856 1 other NPI on this enrollment
Practice locations: Greenport, NY; Stony Brook, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649294026. Details of each certification follow.

Hospital certification: CCN 33S393

Legal name
UNIVERSITY HOSPITAL AT STONY BROOK
Organization structure
GovernmentNon-profit
Enrollment address
100 Nicolls Rd
Stony Brook, NY 11794-8101
Hospital Psychiatric Unit
Hospital subgroups
Acute care, Psychiatric, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
University Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
University Hospital at Stony Brook Organization, Stony Brook, NY Other Jul 1, 2019 100%
Carol Gomes Individual W-2 Managing EmployeeChief Executive Officer Jun 15, 2019 100%
Gary E Bie Individual Corporate OfficerCfo Jan 1, 2017
Operational/Managerial ControlCfo Jul 1, 2019 100%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University Hospital at Stony BrookStony Brook, NY, CCN 330393 Hospital 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Jan 10, 1980
Jan 1, 2019

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352678400000",
    "number": "1649294026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117949112",
            "telephone_number": "631-444-4100",
            "fax_number": "631-444-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117949112",
            "telephone_number": "631-444-4100",
            "fax_number": "631-444-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITAL AT STONY BROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-11-12",
        "status": "A",
        "authorized_official_last_name": "BIE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-444-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NY",
            "license": "5151001H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stony Brook University Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.