NPIMap

Organization Active NPI

Belle Terre Medical Wellness, PC

  • Clinic/Center
  • Port Jefferson, NY
National Provider Identifier
1649848300
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BELLE TERRE MEDICAL WELLNESS, PC
Practice address
640 Belle Terre Rd BLDG J
Port Jefferson, NY 11777-1936
Phone
(631) 828-5361
NPI assigned
Jun 17, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Markella Christakis, MD, MSPHNPI 1154632172
Title
Owner
Phone
(631) 403-4310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

640 Belle Terre Rd BLDG J
Port Jefferson, NY 11777-1936

Mailing address

640 Belle Terre Rd BLDG J
Port Jefferson, NY 11777-1936

National Provider Directory

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1649848300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 BELLE TERRE RD BLDG J",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 BELLE TERRE RD BLDG J",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771936",
            "telephone_number": "631-828-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLE TERRE MEDICAL WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "CHRISTAKIS",
        "authorized_official_first_name": "MARKELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-403-4310",
        "authorized_official_credential": "MD, MSPH"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.