NPIMap

Organization Active NPI

Suffolk County Department of Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Farmingville, NY
National Provider Identifier
1700989050
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6919102A Issued in NY
Legal business name
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
Practice address
15 Horseblock PL
Farmingville, NY 11738-1204
Phone
(631) 854-2552
Fax
(631) 854-2550
NPI assigned
Sep 5, 2006
Last updated
Oct 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Dr. Humayun J Chaudhry, D.O., M.S.
Title
Commissioner
Phone
(631) 853-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6919102A NY Primary

Addresses

Primary practice location

15 Horseblock PL
Farmingville, NY 11738-1204

Mailing address

225 Rabro Dr
Hauppauge, NY 11788-4241
Phone (631) 853-3000

Other identifiers 1

IdentifierTypeStateIssuer
00354807MedicaidNY

Other names 1

  • Farmingville Mental Health Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000525 NY Part B Supplier - Clinic/Group Practice 2264344316 Receives reassigned benefits from 17 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Farmingville, NY; Riverhead, NY; Yaphank, NY

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Patricia a Centamore17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 10

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": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1700989050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 RABRO DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884241",
            "telephone_number": "631-853-3000",
            "fax_number": "631-853-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HORSEBLOCK PL",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381204",
            "telephone_number": "631-854-2552",
            "fax_number": "631-854-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "CHAUDHRY",
        "authorized_official_first_name": "HUMAYUN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COMMISSIONER",
        "authorized_official_telephone_number": "631-853-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O., M.S."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "6919102A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354807",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmingville Mental Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmingville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.