NPIMap

Organization Active NPI

CHS Physician Partners, PC

  • Cardiovascular Disease Physician
  • West Islip, NY
National Provider Identifier
1659502425
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
107338 Issued in NY
Legal business name
CHS PHYSICIAN PARTNERS, PC
Practice address
540 Union Blvd
West Islip, NY 11795
Phone
(631) 669-2555
NPI assigned
Jul 28, 2009
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
Jack Soterakis, MD
Title
President
Phone
(516) 562-6231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 107338 NY Primary

Addresses

Primary practice location

540 Union Blvd
West Islip, NY 11795

Mailing address

PO Box 95000-6625
Philadelphia, PA 19195-6625

Other names 1

  • South Bay Cardiovascular Associates 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

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1659502425",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 UNION BLVD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "11795",
            "telephone_number": "631-669-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHYSICIAN PARTNERS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS PHYSICIAN PARTNERS, PC",
        "enumeration_date": "2009-07-28",
        "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_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "107338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bay Cardiovascular Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Bay Cardiovascular Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Islip, 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.