NPIMap

Organization Active NPI

Good Samaritan Hospital Medical Center

  • Home Health Agency
  • Bay Shore, NY
National Provider Identifier
1700885472
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
5101600 Issued in NY
Legal business name
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
Practice address
15 Park Ave
Suite 200
Bay Shore, NY 11706-7381
Phone
(631) 969-8200
NPI assigned
Jul 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Authorized official

Name
Mary Ellen Polit
Title
Administrator
Phone
(631) 969-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5101600 NY Primary

Addresses

Primary practice location

15 Park Ave
Suite 200
Bay Shore, NY 11706-7381

Mailing address

15 Park Ave
Bay Shore, NY 11706-7381
Phone (631) 969-8200

Other identifiers 1

IdentifierTypeStateIssuer
00274346MedicaidNY

Other names 1

  • Good Samaritan Home Health Agency Other name

National Provider Directory

National Provider Directory

Locations

245 Old Country Rd
Fl 2
Melville, NY 11747

Practitioners & affiliated clinicians

Practitioners 12

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": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1700885472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARK AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067381",
            "telephone_number": "631-969-8200",
            "fax_number": "631-224-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARK AVE",
            "address_2": "SUITE 200",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067381",
            "telephone_number": "631-969-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "POLIT",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-969-8200"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "5101600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00274346",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Home Health Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.