NPIMap

Individual provider Active NPI

Kelley Sookraj

  • Surgical Critical Care Physician
  • Patchogue, NY
National Provider Identifier
1689852386
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
269343 Issued in NY
Practice address
4 Phyllis Dr Ste B
Patchogue, NY 11772-2900
Phone
(631) 289-4700
NPI assigned
Feb 5, 2008
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 269343 NY Primary

Addresses

Primary practice location

4 Phyllis Dr Ste B
Patchogue, NY 11772-2900

Mailing address

4 Phyllis Dr Ste B
Patchogue, NY 11772-2900
Phone (631) 289-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170111001500 NY Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 9537440268 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
St Catherine of Siena Medical CenterGroup PAC ID 0941267876, 95 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401

Merit-based Incentive Payment System (MIPS)

Final score
85.89 of 100Reported as group
Quality
59.29
Promoting interoperability
89
Improvement activities
40
Cost
76.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
269343NYMDSurgical Critical Care Physician

Practice roles (8 of 12)

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Nov 20, 2016 Accepting new patients
New York University CurrentSince Mar 28, 2025 Accepting new patients
Nassau Health Care Corporation CurrentSince Nov 20, 2016 Accepting new patients
St. Catherine of Siena Medical Center CurrentSince Feb 17, 2025 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients
Long Island Surgery P.C. Surgical Critical Care CurrentSince Nov 1, 2022 Accepting new patients
New York University CurrentSince Mar 28, 2025 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

100 Hospital Rd
Ste 115
East Patchogue, NY 11772
Phone (631) 228-5830

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

4 Phyllis Dr
Ste B
Patchogue, NY 11772
Phone (631) 289-4700

4 Phyllis Dr
Patchogue, NY 11772
Phone (631) 289-4700

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1689852386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PHYLLIS DR STE B",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722900",
            "telephone_number": "631-289-4700",
            "fax_number": "631-289-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PHYLLIS DR STE B",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722900",
            "telephone_number": "631-289-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOKRAJ",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2008-02-05",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "269343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.