NPIMap

Organization Active NPI

Shoreham Medical Services PC

  • Cardiovascular Disease Physician
  • Shoreham, NY
National Provider Identifier
1659655157
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SHOREHAM MEDICAL SERVICES PC
Practice address
45 Route 25a
Shoreham, NY 11786-1389
Phone
(631) 744-3303
Fax
(631) 744-1627
NPI assigned
Oct 3, 2011
Last updated
Oct 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Owen Yen, M.D.NPI 1124111232
Title
Shareholder
Phone
(631) 744-3303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X NY
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X NY Primary

Addresses

Primary practice location

45 Route 25a
Shoreham, NY 11786-1389

Mailing address

45 Route 25a
Shoreham, NY 11786-1389
Phone (631) 744-3303

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": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1659655157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ROUTE 25A",
            "city": "SHOREHAM",
            "state": "NY",
            "postal_code": "117861389",
            "telephone_number": "631-744-3303",
            "fax_number": "631-744-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ROUTE 25A",
            "city": "SHOREHAM",
            "state": "NY",
            "postal_code": "117861389",
            "telephone_number": "631-744-3303",
            "fax_number": "631-744-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREHAM MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "YEN",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "631-744-3303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.