Organization Active NPI

Kinexion LTC Pharmacy LLC

  • Long Term Care Pharmacy
  • Port Jefferson Station, NY
National Provider Identifier
1669349296
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
KINEXION LTC PHARMACY LLC
Practice address
51 Terryville Rd FL 2
Port Jefferson Station, NY 11776-1331
Phone
(631) 509-1470
Fax
(631) 509-1474
NPI assigned
Oct 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Mayur Patel
Title
Member
Phone
(845) 401-5301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

51 Terryville Rd FL 2
Port Jefferson Station, NY 11776-1331

Mailing address

51 Terryville Rd FL 2
Port Jefferson Station, NY 11776-1331
Phone (631) 509-1470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20260415002333 NY Part B Supplier - Pharmacy 9133695406 Practice locations: Port Jefferson Station, NY
O20260415002483 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9133695406 Practice locations: Port Jefferson Station, NY
O20260519002328 NY DME Supplier - Pharmacy 9133695406 Practice locations: Port Jefferson Station, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Kinexion LTC Pharmacy LLC51 Terryville Rd, Port Jefferson Stati, NY 11776-1331(631) 509-1470 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Apr 23, 2026

National Provider Directory

National Provider Directory

Locations

51 Terryville Rd
Fl 2
Port Jefferson Station, NY 11776
Phone (631) 509-1470

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1669349296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 TERRYVILLE RD FL 2",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761331",
            "telephone_number": "631-509-1470",
            "fax_number": "631-938-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 TERRYVILLE RD FL 2",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761331",
            "telephone_number": "631-509-1470",
            "fax_number": "631-509-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINEXION LTC PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAYUR",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "845-401-5301"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.